P31. Lateral interface pressures during a spinal procedure: can we optimize positioning?

BACKGROUND CONTEXT Prolonged surgical procedures have an increased risk of pressure and nerve injuries. Lateral lumbar interbody fusion (LLIF) procedures require patient positioning with tape to secure and minimize movement of the patient. Decreased interface pressures have previously been attributed to increased patient comfort. We assessed the preoperative interface pressures for a LLIF procedure. PURPOSE Lateral peak interface pressures on a flat surgical table is increased with taping during patient positioning. STUDY DESIGN/SETTING Prospective. PATIENT SAMPLE Peak pressures were measured in four phases of patient positioning: lateral (n=93 frames), lateral + axilla pad (n=43 frames), lateral + axilla pad + taping (n=506 frames), and lateral + axilla pad + taping + draping (n=414 frames). Peak pressure measurements were captured over a timeframe of minimal contact to the patient. Four regions were assessed: the shoulder, right thorax, hip and leg. OUTCOME MEASURES Peak pressures (mmHg) for the shoulder, right thorax, hip, and leg regions. METHODS Pressure sensors were placed on a flat surgical table. A patient was positioned laterally according to Association of Surgical Technologists Standards of Practice for Surgical Positioning. An axilla pad was placed to support the right thorax and egg crate foam were used to support the lateral side of the right knee. Peak pressures were measured in four phases of patient positioning: lateral (n=93 frames), lateral + axilla pad (n=43 frames), lateral + axilla pad + taping (n=506 frames), and lateral + axilla pad + taping + draping (n=414 frames). Peak pressure measurements were captured over a timeframe of minimal contact to the patient. Four regions were assessed: the shoulder, right thorax, hip and leg. RESULTS Before taping to secure the patient, peak pressures for the shoulder, right thorax, hip, and leg regions were 33.4±0.5 mmHg, 59.5±0.6 mmHg, 68.4±1.0 mmHg, and 50.8±0.8 mmHg. After taping, peak pressures were significantly increased in all regions except the shoulder and legs. Peak pressures were 35.0±0.4 mmHg, 71.1±0.5 mmHg (p CONCLUSIONS Pressure sensors can provide real-time feedback during patient positioning. Securing a patient with tape increases the static pressure applied to a patient in a single position procedure. Optimal techniques to minimize excessive pressure can be identified. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.