Revision Spine Surgery as Additional Risk Factor for Postoperative Visual Loss (POVL) – Report of Two Cases

Giovanni Andrea La Maida*

Department of Spine Surgery, Orthopedic Institute Gaetano Pini, Italy

^*Correspondance to: Giovanni Andrea La Maida 

 PDF  Full Text DOI: 10.25107/2474-1647.3522

Abstract

Introduction: Visual loss in non-ocular surgery occurs infrequently from 0.001% to 1% depending on the type of surgery. In spine surgery patients are often placed in prone position with relatively low incidence of complications position related. Postoperative Visual Loss (POVL) is a very rare catastrophic complication of spine surgery that must be considered when we treat our patients and it’s of great importance to identify potentially risk factors. Methods: We report two cases of unilateral visual loss due to Central Retinal Artery Occlusion (CRAO) after revision spine surgery. Papers were systematically reviewed and additional articles were selected based on cited references. Results: During the last 15 years of spinal surgery, we reported only 2 cases (<0.001%) of POVL due to CRAO, both after long time revision surgery with multiple spinal osteotomies. Both patients had unilateral visual loss after the surgery despite adequate eye protection. Both of them had multiple complication risk factors. Conclusion: This very rare but catastrophic complication must be considered when we plan a challenging revision spine surgery. Patients must be adequately informed about this tremendous risk even in the presence of correct eye protection. Our report will help spine surgeons and anesthesiologists to focus on interprofessional cooperation to obtain an effective informed consent form for prone spinal surgery, especially for revision spine surgery.

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Cite the article

La Maida GA. Revision Spine Surgery as Additional Risk Factor for Postoperative Visual Loss (POVL) – Report of Two Cases. Clin Surg. 2022; 7: 3522..