Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2020; 8(1): 38-45
Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.38
Application of a modified surgical position in anterior approach for total cervical artificial disc replacement
Wen-Xiu Hou, Hao-Xuan Zhang, Xia Wang, Hai-Ling Yang, Xiao-Rong Luan
Wen-Xiu Hou, Xia Wang, Xiao-Rong Luan, Third Ward of Orthopedics Department, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
Hao-Xuan Zhang, Department of Spine Surgery, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
Hai-Ling Yang, Department of Nursing, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
Author contributions: Hou WX, Luan XR, and Zhang HX designed the research; Wang X and Yang HL performed the research; Hou WX and Luan XR wrote the paper.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Qilu Hospital, Shandong University.
Informed consent statement: Written informed consent was obtained from the patients.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article are reported.
Data sharing statement: All the data in the current research are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Xiao-Rong Luan, MNurs, PhD, Chief Nurse, Third Ward of Orthopedics Department, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China.
Received: August 20, 2019
Peer-review started: August 20, 2019
First decision: September 9, 2019
Revised: October 15, 2019
Accepted: October 30, 2019
Article in press: October 30, 2019
Published online: January 6, 2020
Research background

Total cervical artificial disc replacement (TDR) has been considered a safe and effective alternative surgical treatment for cervical spondylosis and degenerative disc disease that have failed to improve with conservative methods.

Research motivation

Positioning the surgical patient is a critical part of the procedure. Appropriate patient positioning is crucial not only for the safety of the patient but also for optimizing surgical exposure, ensuring adequate and safe anesthesia, and allowing the surgeon to operate comfortably during lengthy procedures. The surgical posture is the traditional position used in anterior cervical approach; in general, patients are in a supine position with a pad under their shoulders and a ring-shaped pillow under their head. The activity of the adjacent segment accelerates the degeneration of the adjacent layers and causes new symptoms.

Research objectives

To investigate the clinical outcomes of the use of a modified surgical position versus the traditional surgical position in anterior approach for TDR.

Research methods

In the modified position group, patients had a soft pillow under their neck, and their jaw and both shoulders were fixed with wide tape. The analyzed data included intraoperative blood loss, position setting time, total operation time, and perioperative blood pressure and heart rate.

Research results

Blood pressure and heart rate were not significantly different before and after body positioning in both groups. Compared with the traditional position group, the modified position group showed a statistically significantly longer position setting time. However, the total operation time and intraoperative blood loss were significantly reduced in the modified position group compared with the traditional position group.

Research conclusions

The clinical outcomes indicated that total operation time and intraoperative blood loss were lower in the modified position group than in the traditional position group, thus reducing the risks of surgery while increasing the position setting time.

Research perspectives

The modified surgical position is a safe and effective method to be used in anterior approach for TDR surgery.