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Kneeling Increases Leg Pressure During Spinal Surgery

May raise risk of acute compartment syndrome

MONDAY, Sept. 10 (HealthDay News) -- The kneeling position adopted during spinal surgery increases intramuscular pressure in the anterior compartment of the leg, which may increase the risk of acute compartment syndrome, researchers report in the September issue of the Journal of Bone & Joint Surgery.

Bryan T. Leek, M.D., and colleagues from the University of California at San Diego Medical Center measured intramuscular pressure in all four left leg compartments in eight healthy volunteers while in the 90/90 kneeling position (with 90 degrees of both hip and knee flexion), the 45/45 suspended position (with the hips and knees both flexed to 45 degrees), and in the prone position.

The researchers found that the intramuscular pressure in the anterior compartment was significantly higher in the 90/90 kneeling position compared with both other positions. This correlated with subject weight and applied body weight load measured beneath the leg.

"The 90/90 kneeling position results in elevated intramuscular pressure in the anterior compartment of the leg," Leek and colleagues conclude. "The 90/90 kneeling position may predispose patients to the development of an acute compartment syndrome during prolonged spine surgery, with heavier patients being at increased risk."

Abstract
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