caa a22 4500 445834900 CHVBK 20190328074408.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s00586-010-1557-9 doi (NATIONALLICENCE)springer-10.1007/s00586-010-1557-9 Amaurosis after spine surgery: survey of the literature and discussion of one case [Elektronische Daten] [Stephan Zimmerer, Markus Koehler, Stephanie Turtschi, Anja Palmowski-Wolfe, Thierry Girard] Postoperative vision loss (POVL) associated with spine surgery is a well known, albeit very rare complication. POVL incidence after spinal surgery ranges from 0.028 to 0.2%; however, due to the increase in number and duration of annual complex spinal operations, the incidence may increase. Origin and pathogenesis of POVL remain frequently unknown. A 73-year-old patient presented with lumbar disc herniation with associated neurological deficits after conservative pre-treatment at a peripheral hospital. Known comorbidities included arterial hypertension, moderate arterial sclerosis, diabetes mellitus type 2, mildly elevated blood lipids and treated prostate gland cancer. During lumbar spine surgery in modified prone position the patient presented with an acute episode of severe hypotension, which required treatment with catecholamines and Trendelenburg positioning. Three hours postoperatively, a visual loss in the right eye occurred, resulting in a complete amaurosis. Antihypertensive medication, arteriosclerosis and intraoperative hypotension are possible causes for the POVL. Intraoperative administration of catecholamines and Trendelenburg positioning for treatment of systemic hypotension might further compromise ocular perfusion. In patients with comorbidities compromising arterial blood pressure, blood circulation and microcirculation, POVL must be considered as a severe postoperative complication. It is recommended to inform patients about such complications and obtain preoperative informed consent regarding POVL. Any recent modification of antihypertensive medication must be reported and analysed for potential intraoperative hemodynamic consequences, prior to spine surgery in prone position. Springer-Verlag, 2010 Amaurosis nationallicence Blood pressure nationallicence Spinal surgery nationallicence Prone position nationallicence Postoperative vision loss (POVL) nationallicence Zimmerer Stephan Department of Neurosurgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland aut Koehler Markus Bethesda Spital Basel, Gellertstr. 144, 4052, Basel, Switzerland aut Turtschi Stephanie Department of Ophthalmology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland aut Palmowski-Wolfe Anja Department of Ophthalmology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland aut Girard Thierry Department of Anaesthesia, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland aut European Spine Journal Springer-Verlag 20/2(2011-02-01), 171-176 0940-6719 20:2<171 2011 20 586 https://doi.org/10.1007/s00586-010-1557-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1557-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Zimmerer Stephan Department of Neurosurgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland aut NATIONALLICENCE 700 1- Koehler Markus Bethesda Spital Basel, Gellertstr. 144, 4052, Basel, Switzerland aut NATIONALLICENCE 700 1- Turtschi Stephanie Department of Ophthalmology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland aut NATIONALLICENCE 700 1- Palmowski-Wolfe Anja Department of Ophthalmology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland aut NATIONALLICENCE 700 1- Girard Thierry Department of Anaesthesia, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/2(2011-02-01), 171-176 0940-6719 20:2<171 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer