Perioperative Blood Pressure Management for Patients Undergoing Spinal Fusion for Pediatric Spinal Deformity Current Concept Review

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Nicholas D. Fletcher
Ravi Ghag
Daniel J. Hedequist
Meghan N. Imrie
James T. Bennett
Michael P. Glotzbecker
POSNA QSVI Spine Committee

Abstract

Posterior spinal instrumentation and fusion has become the gold standard for definitive management of children and adolescents with spinal deformity. Despite continued innovations designed to improve the safety profile of this complex surgical undertaking, spinal cord injury and resulting loss of neurologic function remain a rare but devastating risk. The increasing power of instrumentation combined with more aggressive correction strategies puts the spinal cord at particular risk due to traction. While the surgeon has the luxury of complex neuromonitoring techniques to alert the team in the presence of a neurologic change during surgery, maintenance of spinal cord perfusion throughout surgery and in the early postoperative period should be considered to avoid spinal cord ischemia as it accommodates to its new position after deformity correction. This manuscript represents recommendations of the POSNA Quality, Value, and Safety spine committee for optimization of blood pressure in the perioperative period.

Article Details

How to Cite
Fletcher, N., Ghag, R., Hedequist, D., Imrie, M., Bennett, J., Glotzbecker, M., & POSNA QSVI Spine Committee. (2023). Perioperative Blood Pressure Management for Patients Undergoing Spinal Fusion for Pediatric Spinal Deformity: Current Concept Review. Journal of the Pediatric Orthopaedic Society of North America, 5(1). https://doi.org/10.55275/JPOSNA-2023-602
Section
Spine
Author Biographies

Nicholas D. Fletcher

Professor of Orthopaedic Surgery

Ravi Ghag

Assistant Professor of Orthopaedics

Daniel J. Hedequist

Associate Professor of Orthopaedics

Meghan N. Imrie

Associate Professor of Orthopaedics

Michael P. Glotzbecker

Associate Professor of Orthopaedics