Perioperative Vision Loss Following Prone Spine Surgery: A Case-Control Study

Abstract

PurposePerioperative vision loss (POVL) is a rare and devastating complication following prone spine surgery. Due to the rare nature of this complication, there is limited research available about patient and surgical risk factors that increase the risk of POVL. Study DesignThis study utilized a case-control secondary data analysis methodology that included 5 cases of POVL and 250 controls from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database who all underwent prone spine surgery between 2010-2020. MethodsEach POVL case was matched to 50 randomly selected controls (n = 250) based on type and year of surgery. Demographics and variables of interest were compared among the POVL cases, among POVL cases and the aggregate control group (n = 250), and POVL cases against their matched control group. Univariate and multivariate conditional logistic regression were then used to estimate the odds of developing POVL in relation to potential patient and surgical risk factors. FindingsWhen POVL cases were compared to the 250 control cases using univariate analysis, patients who developed POVL were more likely to have received a blood transfusion within 72 hours of surgery (p < 0.0001). and have longer operative times (OR =1.01, 95% CI [1.003, 1.017], p = 0.003). ConclusionsTwo surgical risk factors were determined to be statistically significant, including the need for perioperative blood transfusion and prolonged operative time. These findings support previous research on POVL which often identified blood loss and prolonged operative times as surgical risk factors. The narrow patient population used in this project may have limited the ability to perform a more robust study on POVL. Therefore, further research on POVL using the NSQIP database is strongly encouraged.