The effect of increasing degrees of spinal flexion on cerebrospinal fluid pressure

Anaesthesia
J DinsmoreT E Hollway

Abstract

The effects of increasing degrees of flexion on cerebrospinal fluid pressure were investigated in 12 neurosurgical patients requiring lumbar subarachnoid drains. Cerebrospinal fluid pressure and central venous pressure were measured in three positions: fully flexed ('chin on chest'), flexed at ninety degrees and straight. There was a significant increase in cerebrospinal fluid pressure on moving from the fully flexed to the flexed position (p < 0.0001), but not from the flexed to the straight position. These results were mirrored by smaller changes in central venous pressure. In patients without intracranial pathology these increases in cerebrospinal fluid pressure are probably unimportant. However, intracranial pathology may result in low cerebral perfusion pressures and any increase in cerebrospinal fluid pressure in this group may be harmful. The fully flexed position should be avoided when inserting lumbar drains in at risk patients.

References

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May 1, 1993·Neurosurgery·J HamadaY Ushio

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Citations

Dec 14, 1999·Anaesthesia·T M Cook
May 13, 2010·British Journal of Anaesthesia·M CarronC Ori
Aug 19, 2014·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Sarah C M Lee, Christian J Lueck
Aug 19, 2014·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Robert A Avery
May 2, 2014·Journal of Neurosurgical Anesthesiology·Pothapragada K ChakravarthyGeorgene Singh
May 20, 2015·Lancet Neurology·Anne Ducros, Valérie Biousse
Jan 28, 2015·Indian Journal of Anaesthesia·Padmaja Durga, Barada Prasad Sahu
Aug 22, 2000·Journal of Manipulative and Physiological Therapeutics·C G Davis
Aug 30, 2019·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Khin P KilgoreJohn J Chen
Apr 3, 2021·Acta neurochirurgica·Sarah H PedersenMarianne Juhler

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