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. 2013 Jul;22(7):1474-9.
doi: 10.1007/s00586-012-2653-9. Epub 2013 Jan 13.

Modified prone position using lateral brace attachments for cervico-dorsal spine surgeries

Abhijeet B Kadam  1 , Abhishek S Jaipuria, Ashok K Rathod
Affiliations

Modified prone position using lateral brace attachments for cervico-dorsal spine surgeries

Abhijeet B Kadam et al. Eur Spine J. 2013 Jul.

Abstract

Purpose: The purpose of the study was to propose a method of prone positioning for posterior cervico-dorsal spine surgeries that is easy to achieve without additional equipment and may reduce complications associated with prone positioning in patients.

Methods: 41 patients underwent posterior spine surgeries using our method of prone positioning on a fluoroscopy compatible conventional operation table, and the technical difficulties and complications associated were noted. After induction under general anaesthesia in supine position, cervical tongs were applied. An assembly of two adequately padded cylindrical bolsters and two lateral brace attachments was set on a conventional operating table. The patient was then positioned prone so that the tongs as well as insertion pins of the tongs rest on the lateral brace attachments, with the face and head suspended freely in between. A neutralisation weight was then applied suspended from the tongs to stabilize the head.

Results: The time required for patient positioning was noted and was found to be nearly the same as that required for traditional prone positioning. No problems were noted during patient positioning and with anaesthesia tubing management. All surgeries went well without position related complications except for one patient who developed post-operative macroglossia. All cervical tong pin sites healed without any complications. The fluoroscope easily gained access to the operative areas.

Conclusions: Our modification appears simple, versatile and reproducible for posterior approach procedures of the cervical and upper dorsal spine in prone position. Also, the method can be easily implemented in most conventional operating room facilities with minimal surgeon effort and without the need for any additional inventory.

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Figures

Figs. 1, 2
Figs. 1, 2
The assembly of two adequately padded cylindrical bolsters and two lateral brace attachments set on a conventional operating table as seen from different angles
Figs. 3, 4
Figs. 3, 4
The patient positioned prone with cervical tongs resting on lateral brace attachments. Note that the face and head are suspended freely
Figs. 5, 6
Figs. 5, 6
Neutralisation traction weight applied, suspended over a wooden block fixed at the head end of table
Figs. 7, 8
Figs. 7, 8
Note the easy access to the anaesthesia tubings facilitated by the position
See this image and copyright information in PMC

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