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Superior Vena Cava Compression During Posterior Spinal Fusion for Idiopathic ScoliosisA Case Report
Kathleen A. Hogan, MD1; Susan C. Harvey, MD1; William F. Conway, MD, PhD1; John F. DeRosimo, MD1; Richard H. Gross, MD1
1 Departments of Orthopaedic Surgery (K.A.H. and R.G.), Anesthesiology (S.H.), Radiology (W.F.C.), and Surgery (J.F.D.), Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 708, Charleston, SC 29425. E-mail address for R. Gross: grossr@musc.edu
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Investigation performed at the Medical University of South Carolina, Charleston, South Carolina

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Mar 01;91(3):696-700. doi: 10.2106/JBJS.H.00208
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Known complications of prone positioning for spinal surgery include visual impairment, blindness, meralgia paresthetica, and elevated intra-abdominal pressure1-3. There are a plethora of positioning frames and tables available for spinal surgery. Much of the focus in positioning the patient is to leave the abdomen hanging freely in order to reduce intra-abdominal pressure. Elevated abdominal pressures have been shown to lead to elevated inferior vena cava pressure, which results in increased blood loss during surgery4,5. In this report, we discuss a patient who had temporary compression of the superior vena cava caused by prone positioning on the patient chest pad of the Jackson spinal table during surgery. The patient and her family were informed that data concerning the case would be submitted for publication, and they consented.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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