Asian Spine J Search


Asian Spine J > Volume 17(6); 2023 > Article
Yamaguchi, Morimoto, Hirata, and Mawatari: Letter to the Editor: Patient Positioning in Spine Surgery: What Spine Surgeons Should Know?
Dear Editor,
We were intrigued by the article by Garg et al. [1], which discussed position-related complications associated with the prone position. However, we still have some concerns about the article.
First, we aim to prevent perioperative vision loss. While it is commonly associated with the prone position, this study reported occurrences in the side-lying position. Given the mechanisms and risk factors, it may also occur in the supine position. However, what is the actual prevalence?
Second, postoperative nausea and vomiting warrants to be avoided, particularly in cases that require a resting postoperative position, such as in anterior cervical spine surgery. Is there any difference in the incidence of postoperative nausea and vomiting based on the patient’s position or use of a headrest? Likewise, is there any variation in the occurrence of postoperative delirium based on the patient’s position?
Third, various nutritional indices are now available [2,3], and their association with postoperative infections is being examined. Is there any connection between nutritional indices and pressure ulcers resulting from body positioning?
Finally, some facilities perform decompression every few hours during prolonged surgery to prevent pressure ulcers and upper extremity peripheral neuropathy. Do the authors use a similar management? Furthermore, is this management considered effective in the literature?
To improve our understanding of your excellent research, we look forward to hearing from you regarding our submission. We would be glad to respond to all your questions and comments.


Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Author Contributions

All authors provided the same amount of effort for the preparation of this commentary.


1. Garg B, Bansal T, Mehta N, Sharan AD. Patient positioning in spine surgery: what spine surgeons should know? Asian Spine J 2023 17:770–81.
crossref pmid pmc pdf
2. Oe S, Togawa D, Yamato Y, et al. Preoperative age and prognostic nutritional index are useful factors for evaluating postoperative delirium among patients with adult spinal deformity. Spine (Phila Pa 1976) 2019 44:472–8.
crossref pmid
3. Sakai M, Sohda M, Saito H, et al. Comparative analysis of immunoinflammatory and nutritional measures in surgically resected esophageal cancer: a singlecenter retrospective study. In Vivo 2020 34:881–7.
crossref pmid pmc


Browse all articles >

Editorial Office
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine
88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Tel: +82-2-3010-3530    Fax: +82-2-3010-8555    E-mail:                
Korean Society of Spine Surgery
27, Dongguk-ro, Ilsandong-gu, Goyang-si 10326, Korea
Tel: +82-31-966-3413    Fax: +82-2-831-3414    E-mail:                

Copyright © 2024 by Korean Society of Spine Surgery.

Developed in M2PI

Close layer
prev next