Perioperative Considerations and Positioning for Neurosurgical Procedures

1. Front Matter

   Pages i-xix

   PDF

2. Positioning Patients for Neurosurgical Procedures: A Historical Perspective

   • Mallory Roberts, Jon H. Robertson

   Pages 1-18

3. Biomechanics and the Mathematics of Positioning

   • George F. Young

   Pages 19-25

4. Anesthesia and Patient Positioning

   • C. Wayne Hamm

   Pages 27-50

5. Preoperative Assessment of the Patient for the Planned Position

   • C. Wayne Hamm, Jaafar Basma

   Pages 51-63

6. Organization of the Operating Room for Neurosurgical Procedures

   • Jaafar Basma, Daniel Hoit

   Pages 65-79

7. Overall Positioning Considerations for Intracranial Procedures

   • Adam Arthur

   Pages 81-82

8. Intracranial Procedures in the Supine, Semi-Sitting, and Sitting Positions

   • Jaafar Basma, Vincent Nguyen, Jeffrey Sorenson

   Pages 83-100

9. Intracranial Procedures in the Lateral Position

   • L. Madison Michael II, Douglas R. Taylor

   Pages 101-110

10. Intracranial Procedures in the Prone Position

    • Mirza Pojskic, Kenan I. Arnautovic

    Pages 111-131

11. Spinal Surgery Positioning Overview

    • Kevin Foley

    Pages 133-135

12. The Supine, Sitting, and Lithotomy Positions

    • Shaheryar F. Ansari, Jean-Pierre Mobasser

    Pages 137-147

13. Spinal Procedures in the Lateral Position

    • Matthew T. Brown, Raul Cardenas, Julius Fernandez

    Pages 149-158

14. Spinal Procedures in the Prone Position

    • Prayash Patel, Christopher Nickele

    Pages 159-174

15. Special Considerations in Positioning for Neurosurgical Tumors: Spinal

    • Jason A. Weaver

    Pages 175-190

16. Special Considerations for Intracranial Tumors

    • Pascal O. Zinn, Ganesh Rao

    Pages 191-204

17. Special Considerations for Pediatric Positioning for Neurosurgical Procedures

    • Michael DeCuypere

    Pages 205-212

18. Comorbidities and Positioning: Morbid Obesity and Multiple Trauma

    • Emily P. Sieg, Shelly D. Timmons

    Pages 213-222

19. Comorbidities and Positioning: Pregnancy

    • Thomas Scott Guyton

    Pages 223-239

20. Postoperative Positioning in the Neurointensive Care Unit

    • Abhi Pandhi, Lucas Elijovich

    Pages 241-249

There are relationships that exist between neuroanesthesia, neurosurgical procedures, individual patient pathology and the positioning of a patient for said procedure.  A comprehensive examination of these relationships, their association with patient morbidity/mortality and how to approach these issues in an evidence-based manner has yet to become available. Positioning related injuries have been documented as major contributors to neurosurgical/neuroanesthesiology liability.


This text examines these relationships. It provides considerations necessary to the correct positioning of a patient for a neurosurgical procedure for each individual patient and their individual pathology. In other words, this text will demonstrate how to construct the necessary surgical posture for the indicated neurosurgical procedure given the individual constraints of the patient within the environment of anesthesia and conforming to existing evidence-based practice guidelines. Sections will address physiological changes inherent in positioning in relation to anesthesia for neurosurgical procedures, assessment of patient for planned procedure, as well as considerations for managing problems associated with these relationships. Additional sections will examine the relationship between neurosurgical positioning and medical malpractice and the biomechanical science between positioning devices and neurosurgical procedures.


Neurosurgery and its patient population are in a constant state of change. Providing the necessary considerations for the neurosurgical procedure planned under the anesthesia conditions planned in the position planned, often in the absence of multicase study literary support, without incurring additional morbidity is the goal of this text.

• Patient position
• lithotomy position
• Positioning pregnant patients
• patient transportation
• Positioning devices

“Perioperative Considerations and Positioning for Neurosurgical Procedures: A Clinical Guide … aims to serve as the authoritative textbook regarding the positioning and preoperative assessment of the neurosurgical patient. … The aforementioned text is intended for neurosurgical practitioners of all ages and skill levels, but would best be set on a reference bookshelf in a neurosurgical resident call room. The strengths of this book include its accessibility/easy prose, the numerous pearls about positioning for surgical procedures, and the instructive photographs contained within.” (David P. Bray, Operative Neurosurgery, Vol. 17 (1), July, 2019)

• Semmes-Murphey Neurologic and Spine Clinic, Memphis, USA

  Adam Arthur, Kevin Foley

• Medical Anesthesia Group, Germantown, USA

  C. Wayne Hamm

Adam S. Arthur MD MPH FAANS FAHA FACS
Professor of Neurosurgery
University of Tennessee Health Sciences Center
Semmes-Murphey Neurological and Spine Clinic
Memphis, TN
USA

 

Kevin T. Foley, MD, FACS
Professor of Neurosurgery, Orthopaedic Surgery, & Biomedical Engineering
University of Tennessee Health Science Center
Chairman, Semmes-Murphey Clinic
Memphis, TN 
USA

 

C. Wayne Hamm CRNA, MSN, APN
Germantown, TN 
USA

 

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