İsmet Topçu, Cüneyt Temiz, Arzu Açıkel, Gönül Tezcan Keleş

Comparison of spinal and cerebral oxygen saturation with near-infrared spectroscopy method during spinal surgery in prone position

Objectives: To assess spinal and cerebral oxygenation with near-infrared spectroscopy method during spinalsurgery in prone position.Methods: This prospective study included 64 patients, who were prepared for posterior spinal instrumentationand laminectomy surgeries. Group 1: 31 patients who had posterior spinal instrumentation; Group 2: 33 patientswho had at least two levels of disk operation (Laminectomy). The following were recorded for all patientsbefore and after anesthesia induction in supine position, after induction in prone position, during operation(beginning, middle and end of surgery) in prone position and before waking up in supine position: cerebraloxygen saturation (NIRSs) measurements, spinal oxygen saturation (NIRSp) measurements, peripheral oxygensaturation (SpO2), heart rate (HR), invasively monitored systolic arterial pressure (SAP), diastolic arterialpressure (DAP), mean arterial pressure (MAP) values.Results: There was no significant difference between two groups in terms of the variables of age, weight,anesthesia and surgery duration (p > 0.05). MAP values were significantly different in both groups beforeinduction, during operation and postoperative periods (p < 0.05). NIRSs were significantly lower at midoperation and at the end of operation (p < 0.05). NIRSp values had no significant difference in any period (p> 0.05). We found no significant difference between groups in HR, SAP, DAP, MAP, NIRSs and NIRSpparameters (p > 0.05) compared at different times.Conclusions: MAP dropped depending on induction and prone position. Cerebral oxygenation significantlydecreased at the time of mid-operation and at the end of operation but spinal oxygenation had no significantdecresase. Compared to laminectomy, posterior stabilization surgery did not pose an additional risk to thepatients in terms of spinal and oxygen saturation.

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