ArticleJournal of orthopaedic case reports2026
Post-operative Desaturation in Prone Spine Surgery; Diagnostic Dilemma in Pneumothorax Due to Barotrauma: A Case Report.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Prone positioning for spine surgery can present with life-threatening pulmonary complications like post-operative pneumothorax, due to barotrauma. Case Report: A 51-year-old male with chronic instability type mid back pain and radiological features of thoracolumbar spondylodiscitis, underwent posterior stabilization, debridement and fusion under general anesthesia in prone position, without any intraoperative event. Immediately post-extubation, he developed acute dyspnea and pulmonary desaturation, for which he was treated with supportive care and was able to maintain satisfactory saturation and observed in the intensive care unit with monitoring. Persistent pulmonary desaturation and requirement of high flow oxygen led to diagnostic intervention with high-resolution computed tomography chest, which showed a small left apical pneumothorax without pleural breach, rib fracture or hemothorax. The patient did not require any invasive intervention and was managed by multidisciplinary team with oxygen therapy, non-invasive ventilation and pulmonary rehabilitation, with an uneventful recovery of pulmonary function and complete resolution of the pneumothorax by 3 weeks post-operative. He was administered appropriate medical management for spondylodiscitis. Conclusion: Post-operative pneumothorax following prone spine surgery, likely from barotrauma, is a rare but potentially catastrophic complication that warrants high clinical vigilance, possible detection of asymptomatic bullae in pre-operative chest imaging. Early recognition, prompt imaging and coordinated multidisciplinary management are essential for optimal outcomes.
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