Hyperbaric oxygenation therapy treatment option in perioperative visual loss in spine surgery

Authors

  • Catarina Aleixo Porto Spine Unit – Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal Department of Orthopedics, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  • Ricardo Santos Pereira Porto Spine Unit – Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal Department of Orthopedics, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  • Filipe Lima Santos Porto Spine Unit – Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal Department of Orthopedics, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  • Henrique Sousa Porto Spine Unit – Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal Department of Orthopedics, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  • José Carlos Soares Porto Spine Unit – Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal
  • João Pedro Maia Gonçalves Porto Spine Unit – Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20210635

Keywords:

Perioperative vision loss, Hyperbaric oxygen therapy, Spine surgery, Central retinal artery occlusion  

Abstract

Perioperative vision loss (POVL) is a catastrophic complication of spine surgery and several risk factors are identified. As spine fusion surgery is rising in number, POVL incidence is increasing. Preventive strategies can decrease the risk of this complication. Prognosis depends on the level of occlusion and how quickly oxygen supply can be restored to retina. We present a 65-year-old female patient with multiple cardiovascular risk factors that who underwent lumbar fusion. Upon waking up from anesthesia, the patient reported total loss of vision in her left eye. An occlusion of the central retinal artery due to a probable embolic cause was diagnosed and the patient promptly started treatment with anti-aggregation therapy and hyperbaric oxygen therapy (HBOT) with good results. The combination of HBOT with anti-aggregation therapy may have had a synergistic effect contributing to the good outcome presented in this case and may be a good option for the treatment of this patients. 

References

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Published

2021-02-23

Issue

Section

Case Reports