Surgical outcomes of supine PCNL in spinal deformity patients: A tertiary care hospital experience

Urologia. 2022 Sep 19;3915603221127090. doi: 10.1177/03915603221127090. Online ahead of print.

Abstract

Aims and objective: Percutaneous nephrolithotomy (PCNL) is treatment of choice now a days in patients with spinal deformity with large kidney stones. Objectives of our present study to compare in which position it is better to perform and costs minimum complications after surgery.

Methods: A total of 14 patients with spinal deformity having nephrolithiasis were selected randomly. No preferences for age, gender, size, location, and laterality of stone or BMI. All the patients were fit according to AUA guideline criteria for management by PCNL. Preoperative and postoperative data were collected in all operated patients. Descriptive statistics were performed as means, standard deviations, and ranges using Microsoft excel. For categorical variables percentage were used.

Results: A total of 14 patients with spinal deformity having nephrolithiasis underwent PCNL. Seven patients operated in prone position and seven patients operated in modified supine position within approximately 2 years. As compared to prone position in supine position there were reduced operative time, little or no change in Hb concentration, shorter hospital stay, little intraoperative blood loss, and higher significant stone free rate were detected.

Conclusions: Supine PCNL in spinal deformity patients with nephrolithiasis is an alternative to the standard prone PCNL. It provides an additional benefit of large operative field performing the procedure in a single position, reduces total operating time, less anesthesia related complications, less neuromusculoskeletal injury, and reduce physical strain on operating surgeon.

Keywords: American Urological Association; body mass index; modified supine position; percutaneous nephrolithotomy; spinal deformity.