Patients' Perspective on Full Disclosure and Informed Consent Regarding Postoperative Visual Loss Associated With Spinal Surgery in the Prone Position

David M. Corda; Franklin Dexter; Jeffrey J. Pasternak; Terrence L. Trentman; Eric W. Nottmeier; Sorin J. Brull
September 2011
Mayo Clinic Proceedings;Sep2011, Vol. 86 Issue 9, p865
Academic Journal
OBJECTIVE: To determine patients' opinions regarding the person, method, and timing for disclosure of postoperative visual loss (POVL) associated with high-risk surgery. PATIENTS AND METHODS: On the basis of findings of a pilot study involving 219 patients at Mayo Clinic in Florida, we hypothesized that at least 80% of patients would prefer disclosure of POVL by the surgeon, during a face-to-face discussion, before the day of scheduled surgery. To test the hypothesis, we sent a questionnaire to 437 patients who underwent prolonged prone spinal surgical procedures at Mayo Clinic in Rochester, MN, or Mayo Clinic in Arizona from December 1, 2008, to December 31, 2009. RESULTS: Among the 184 respondents, 158 patients gave responses supporting the hypothesis vs 26 with at least 1 response not supporting it, for an observed incidence of 86%. The 2-sided 95% confidence interval is 80% to 91%. CONCLUSION: At least 80% of patients prefer full disclosure of the risk of POVL, by the surgeon, during a face-to-face discussion before the day of scheduled surgery. This finding supports development of a national patient-driven guideline for disclosing the risk of POVL before prone spinal surgery.


Related Articles

  • Nitrous oxide.  // Reactions Weekly;8/16/2008, Issue 1215, p29 

    The article describes the case of a 22-year-old woman who developed nitrous oxide-induced tension pneumocephalus following thoracic spinal cord surgery. It references a study by H. J. Theilen et al, published in the July 2008 issue of the "Journal of Neurosurgical Anesthesiology." The medical...

  • Anatomy of the spinal dorsal root entry zone: its clinical significance. Kirazlı, Özlem; Tatarlı, Necati; Güçlü, Bülent; Ceylan, Davut; Ziyal, İbrahim; Keleş, Evren; Çavdar, Safiye // Acta Neurochirurgica;Dec2014, Vol. 156 Issue 12, p2351 

    Background: The posterolateral sulcus (PLS) is an important surgical landmark, especially for DREZ (dorsal root entry zone) operations. Methods: The present study aimed to show the variations of the PLS using human spinal cord histological sections and report the variability in the number of...

  • Quality of Life and Surgical Outcomes After Soft-Tissue Reconstruction of Complex Oncologic Defects of the Spine and Sacrum. Dolan, Roisin T.; Butler, Joseph S.; Wilson-MacDonald, James; Reynolds, Jeremy; Cogswell, Lucy; Critchley, Paul; Giele, Henk // Journal of Bone & Joint Surgery, American Volume;1/20/2016, Vol. 98 Issue 2, p117 

    Background: Tumor-related spinal surgery has been revolutionized by recent advances in spinal stabilization, modern neuroimaging, and perioperative intensive medicine. This study examines clinical outcomes and factors associated with complications following reconstruction of complex...

  • Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging. AHLSKOG, J. ERIC; GEDA, YONAS E.; GRAFF-RADFORD, NEILL R.; PETERSEN, RONALD C. // Mayo Clinic Proceedings;Sep2011, Vol. 86 Issue 9, p876 

    OBJECTIVE: To determine patients' opinions regarding the person, method, and timing for disclosure of postoperative visual loss (POVL) associated with high-risk surgery. PATIENTS AND METHODS: On the basis of findings of a pilot study involving 219 patients at Mayo Clinic in Florida, we...

  • Significance and function of different spinal collateral compartments following thoracic aortic surgery: immediate versus long-term flow compensation. Meffert, Philipp; Bischoff, Moritz S.; Brenner, Robert; Siepe, Matthias; Beyersdorf, Friedhelm; Kari, Fabian A. // European Journal of Cardio-Thoracic Surgery;May2014, Vol. 45 Issue 5, p799 

    Iatrogenic paraplegia has been accompanying cardiovascular surgery since its beginning. As a result, surgeons have been developing many theories about the exact mechanisms of this devastating complication. Thus, the impact of single arteries that contribute to the spinal perfusion is one of the...

  • The prevention of neural complications in the surgical treatment of scoliosis: the role of the neurophysiological intraoperative monitoring. Pastorelli, F.; Silvestre, M.; Plasmati, R.; Michelucci, R.; Greggi, T.; Morigi, A.; Bacchin, M.; Bonarelli, S.; Cioni, A.; Vommaro, F.; Fini, N.; Lolli, F.; Parisini, P. // European Spine Journal;May2011, Vol. 20, p105 

    Iatrogenic spinal cord injury is the most feared complication of scoliosis surgery. The importance of combined somatosensory evoked potentials (SEP) and motor evoked potentials (MEP) monitoring during spine surgery is well known. The current authors retrospectively evaluated the results of...

  • Spinal Cord Injury Resulting From Injury Missed on CT Scan: The Danger of Relying on CT Alone for Collar Removal. Gebauer, Gregory; Osterman, Meredith; Harrop, James; Vaccaro, Alexander // Clinical Orthopaedics & Related Research;Jun2012, Vol. 470 Issue 6, p1652 

    Background: Strict criteria have been used before removing cervical collars in patients with injuries who have midline pain or are unable to be reliably examined. This sometimes leads to prolonged immobilization in cervical collars or use of MRI to rule out injury. Several studies suggest a...

  • Capacitive Coupling Reduces Instrumentation-related Infection in Rabbit Spines: A Pilot Study. Gilotra, Mohit; Griffith, Cullen; Schiavone, Jason; Nimmagadda, Naren; Noveau, Jenna; Ludwig, Steven // Clinical Orthopaedics & Related Research;Jun2012, Vol. 470 Issue 6, p1646 

    Background: Postoperative spine infections cause considerable morbidity. Patients are subjected to long-term antibiotic regimens and may require further surgery. Delivery of electric current through instrumentation can detach biofilm, allowing better antibiotic penetration and assisting in...

  • The use of antibiotic-impregnated fibrin sealant for the prevention of surgical site infection associated with spinal instrumentation. Tofuku, Katsuhiro; Koga, Hiroaki; Yanase, Mitsuhiro; Komiya, Setsuro // European Spine Journal;Oct2012, Vol. 21 Issue 10, p2027 

    Purpose: The purpose of this study was to determine if the use of antibiotic-impregnated fibrin sealant (AFS) was effective in preventing surgical site infections (SSI) associated with spinal instrumentation. Methods: In a preliminary study, five pieces of vancomycin-impregnated fibrin sealant,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics