Study identifies risk factors for ischemic optic neuropathy after spinal fusion surgery

This large, case-control study found that obesity, male sex, prone positioning, longer anesthetic duration and greater estimated blood loss were significantly and independently associated with ischemic optic neuropathy (ION) after spinal fusion surgery.

The authors reviewed data on 80 adult patients with ION after spinal fusion who were included in a national registry and 315 adult control subjects matched by year of surgery without ION after spinal fusion surgery who were randomly selected from 17 institutions.

Based on the study’s results, the authors suggest that prone spine surgery may acutely increase venous pressure in the head and neck, which may lead to decreased perfusion of the optic nerve, resulting in ION.

They conclude that prediction tables for ION based on this study may help inform patients, surgeons and anesthesiologists of the absolute and relative risk factors and guide decision-making.