Prone spine surgery and perioperative visual loss

Model answer

Framing. For prone spine surgery: secure the airway (reinforced ETT), protect pressure points and eyes, minimise abdominal compression, plan for blood loss and neuromonitoring, and reduce POVL risk by limiting extreme hypotension/anaemia, avoiding direct ocular pressure, and counselling high-risk patients (obesity, male, long multilevel fusion, Wilson frame, large blood loss).^[1]

Must cover. Prone physiology and positioning (airway security, pressure points, abdominal compression, eye protection), POVL types, registry risk factors, transfusion strategy, neuromonitoring implications, and postoperative vision check — exact thresholds per the current references and local protocol. Reported bilateral visual loss after prolonged multilevel prone fusion is the crisis stem; include exact taught figures where relevant (POVL risk factors and eye-protection measures per protocol).^[1]