如果说脊柱手术可能导致患者失明，不仅患者难以相信，就是行医者也很少闻及。事实上，约有千分之一的接受脊柱手术的患者术后出现视力降低，甚至丧失。为何脊柱手术会有如此少见但非常严重的并发症呢？最近来自美国的研究阐明了相关的易患因素，诸如：

１、性别，男性患者术后视力易出现降低。

２、体型，肥胖者接受脊柱手术易影响视力。

３、手术过程中患者的体位，如头部较心脏水平低者易使视力受损。

４、手术时间，手术时间较长者易损害视力。

５、失血，术中失血过多易损害视力。

６、输液，术中因维持血容量而大量输入血液替代品易损害视力。

Risk Factors for Vision Loss After Spine Surgery Identified

Rare complication occurs in as many as one out of every 1,000 spine surgeries, researchers say

THURSDAY, Dec. 29 (HealthDay News) -- Researchers have identified six risk factors linked to blindness after spine surgery, a rare but devastating complication.

Known as ischemic optic neuropathy, or ION, the complication occurs when the optic nerve located behind the eyeball is injured. It is estimated to occur in as many as one in 1,000 spine surgeries. Though rare, it can happen to healthy patients at any age, according to researchers.

For the new study, investigators gathered information from a large national database created by the American Society of Anesthesiologists (ASA) to identify patients who were blinded after spine surgery and compared the data to patients undergoing similar spine surgeries from 17 medical centers in North America but who did not experience vision loss.

The six risk factors associated with blindness or partial blindness included: being male; being obese; use of a surgical frame that places the head lower than the heart; the length of the surgery; amount of blood loss; and the use of certain fluids that replace lost blood.

"Our research represents the largest study performed on this complication to date with very detailed data available for comparison," the study's lead author, Dr. Lorri Lee of the University of Washington, said in an ASA news release. "Our identification of the six major risk factors for ION hopefully means that some of these risk factors can be modified in certain situations, with the potential to decrease the risk of blindness after major back surgery."

The study is published in the January issue of the journal Anesthesiology.

SOURCE: American Society of Anesthesiologists, news release, Dec. 21, 2011