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Preparation posterior procedures

Preparation for posterior procedures

There are three options of patient position for posterior procedures.

The following points are common for all the three options:

  1. The abdomen should hang free to avoid high intraabdominal pressure and subsequent venus pressure causing excessive bleeding of the spine.
  2. The arms/shoulders should be resting comfortably in a 90-90° position of the shoulder and elbow.
  3. Adequate padding needs to be provided to elbows and knees to avoid pressure sores
  4. The toes should hang free
  5. The head is best placed in a face mask to avoid pressure on the eyes and have the endotracheal tube free with the neck in neutral position.
  6. Avoid having the head lower than the rest of the body to reduce the risk of postoperative blindness (due to high hydrostatic pressure in the eyes leading to reduced blood perfusion).
  7. Positioning should attempt to maintain/increase thoracic kyphosis and  optimize lumbar lordosis.
  8. It must be possible to obtain radiographic images in both AP and lateral planes at all times.