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Ophthalmic Complications After Spinal Surgery

Stevens, William R. MD, Maj, MC, United States Army*; Glazer, Paul A. MD*; Kelley, Scott D. MD*,†; Lietman, Thomas M. MD; Bradford, David S. MD*

Complications

Study Design. A retrospective review of 3450 spinal surgeries was performed.

Objectives. To review ophthalmic complications and their etiologies, as well as treatments and outcomes, in patients who have undergone spinal surgery.

Summary of Background Data. Ophthalmic complications after major spinal reconstructive surgery are rare and have not been adequately addressed in the orthopedic literature.

Methods. In a series of 3450 spinal surgeries at three institutions, the authors identified seven patients (incidence = 0.20%) whose postoperative course was complicated by loss of visual acuity. These perioperative ophthalmic complications included posterior optic nerve ischemia, occipital lobe infarcts, and central retinal vein thrombosis. Operative time, estimated blood loss, and medical history of peripheral vascular, cardiovascular, or ophthalmic disease were obtained from the charts, as were follow-up data.

Results. Three patients recovered completely, and one had partial return of visual function. In the remaining three patients, significant visual loss persisted.

Conclusions. The risk of ophthalmic complications with spinal surgery has not been fully appreciated. Because ophthalmic complications in spinal surgery may be reversed with prompt recognition and intervention, it is important for clinicians to be aware of their possible occurrence.

From the Departments of *Orthopaedic Surgery and Anesthesia, University of California at San Francisco, San Francisco, California; and the ‡F. I. Proctor Foundation, San Francisco, CA.

The views expressed in this article are those of the authors and do not reflect the official policy or position of the United States Army, The Department of Defense, or the United States Government.

Acknowledgment date: May 13, 1996.

First revision date: November 8, 1996.

Acceptance date: November 19, 1996.

Device status category: 1.

Address reprint requests to: David S. Bradford, MD; Department of Orthopaedic Surgery; Room MU-320 W, Box 0728; University of California, San Francisco; San Francisco, CA 94143-0728.

© Lippincott-Raven Publishers.