Chiari Malformation Type 1 and Semi-Sitting Position-A Suitable Alternative for Patients with High BMI.

Body mass index Chiari malformation type 1 Morbid obesity Posterior fossa decompression Semi-sitting position Surgical positioning

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
27 Jun 2023
Historique:
received: 15 06 2023
accepted: 16 06 2023
pubmed: 30 6 2023
medline: 30 6 2023
entrez: 29 6 2023
Statut: aheadofprint

Résumé

Chiari I malformation results from a mismatch between the posterior fossa bones and neural components. Management usually relies on surgical treatment. Despite being the most common assumed positioning, the prone position can be challenging in high body mass index (BMI) patients (>40 kg/m Between February 2020 and September 2021, 4 consecutive patients with class III obesity underwent posterior fossa decompression. The authors describe nuances of the positioning and perioperative details. No perioperative complications were reported. These patients are at a lower risk of bleeding and increased intracranial pressure as a consequence of low intra-abdominal pressure and venous return. In this context, the semi-sitting position, with the aid of accurate monitoring for venous air embolism, seems to be an advantageous surgical position in this group of patients. We present our results and technical nuances on positioning high BMI patients for posterior fossa decompression using a semi-sitting position.

Identifiants

pubmed: 37385444
pii: S1878-8750(23)00836-7
doi: 10.1016/j.wneu.2023.06.071
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Raphael Bastianon Santiago (R)

Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA.

Brandon Kaye (B)

Nova Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, Florida, USA.

Vivian Hagerty (V)

Department of Surgery, Florida Atlantic University, Charles E. Schmidt College of Medicine, Boca Raton, Florida, USA.

Mauricio Mandel (M)

Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA.

Rocco Dabecco (R)

Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA.

Assad Ali (A)

Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA.

Michal Obrzut (M)

Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA.

Juan Botero (J)

Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA.

Hamid Borghei-Razavi (H)

Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA. Electronic address: borgheh2@ccf.org.

Badih Adada (B)

Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA.

Classifications MeSH