Inadequate Spinal Anesthesia in Lumbar Spine Surgery Is Related to Volume of the Thecal Sac.

Background: Spinal anesthesia (SA) is used in lumbar surgery, but initial adequate analgesia fails in some patients. In these cases, spinal redosing or conversion to general endotracheal anesthesia is required, both of which are detrimental to the patient experience and surgical workflow.

Methods: We reviewed cases of lumbar surgery performed under SA from 2017-2021.

Spinal anesthesia in elective lumbar spinal surgery.

Spinal anesthesia (SA) is gaining recognition as a safe and efficacious regional alternative to general anesthesia for elective lumbar surgery. However, unfamiliarity with management issues related to its use has limited the adoption of awake spine surgery, despite its benefits. Few centers in the United States routinely offer SA for elective lumbar surgery, and a comprehensive workflow to standardize SA for lumbar surgery is lacking.

A Second Prone Dose Algorithm for Patients Undergoing Spinal Anesthesia During Thoracolumbar Surgeries.

Background: Spinal anesthesia is safe and effective in lumbar surgeries, with numerous advantages over general anesthesia (GA). Nevertheless, 1 major concern preventing the widespread adoption of this anesthetic modality in spine surgeries is the potential for intraprocedural anesthetic failure, resulting in the need to convert to GA intraoperatively.

Objective: To present a novel additional prone dose algorithm for when a first spinal dose fails to achieve the necessary effect.

Periprocedural Polypharmacy in Lumbar Fusions Performed Under Spinal Anesthesia Compared With General Anesthesia.

Background: Spinal anesthesia (SA) is a safe and effective alternative to general endotracheal anesthesia (GEA) for lumbar surgery. Foremost among the reasons to avoid GEA is the desire to minimize postoperative cognitive dysfunction (POCD). Although POCD is a complex and multifactorial entity, the risk of its development has been associated with anesthetic modality and perioperative polypharmacy, among others.

Assessing the impact of spinal versus general anesthesia on postoperative urinary retention in elective spinal surgery patients.

Objective: Postoperative urinary retention (POUR) is a common and vexing complication in elective spine surgery. Efficacious prevention strategies are still lacking, and existing studies focus primarily on identifying risk factors. Spinal anesthesia has become an attractive alternative to general anesthesia in elective lumbar surgery, with the potential of having a differential impact on POUR.

Use of Spinal Anesthesia in Lower Thoracic Spine Surgery: A Case Series.

Background: Spinal anesthesia is a safe and effective alternative to general anesthesia for patients undergoing lumbar spine surgery, and numerous reports have demonstrated its advantages. To the best of our knowledge, no group has specifically reported on the use of spinal anesthesia in thoracic-level spine surgeries because there is a hypothetical risk of injuring the conus medullaris at these levels. With the advantages of spinal anesthesia and the desire for many elderly patients to avoid general anesthesia, our group has uniquely explored the use of this modality on select patients with thoracic pathology requiring surgical intervention.

Safety and feasibility of spinal anesthesia during simple and complex lumbar spine surgery in the extreme elderly (≥80 years of age).

Objective: The extreme elderly population (≥80 years of age) is expected to triple globally by 2050 and surgeries in this age group are likely to increase. Spinal anesthesia has emerged as a safe and effective alternative to general anesthesia in lumbar surgery and may particularly benefit extreme elderly patients concerned with post-operative cognitive dysfunction, poor physiological reserves, and polypharmacy. However, literature supporting its use in this population is lacking and there are potential challenges such as degenerative anatomy and medical comorbidities.

Dataset for carbon footprints of transforaminal lumbar interbody fusions performed under spinal or general anesthesia.

The datasets presented here quantify and compare the relative carbon footprints emitted by general versus spinal anesthesia in patients undergoing single-level transforaminal lumbar interbody fusions (TLIFs). Data were retrospectively collected from electronic medical records of 100 consecutive patients who underwent a single-level TLIF from a single neurosurgeon at a U.S.

Assessing the Environmental Carbon Footprint of Spinal versus General Anesthesia in Single-Level Transforaminal Lumbar Interbody Fusions.

Background: The U.S. health care sector produces approximately 10% of national greenhouse gas emissions, paradoxically harming human health.

Spinal anesthesia in contemporary and complex lumbar spine surgery: experience with 343 cases.

Objective: Spinal anesthesia (SA) is an alternative to general anesthesia (GA) for lumbar spine surgery, including complex instrumented fusion, although there are relatively few outcome data available. The authors discuss their experience using SA in a modern complex lumbar spine surgery practice to describe its utility and implementation.

Methods: Data from patients receiving SA for lumbar spine surgery by one surgeon from March 2017 to December 2020 were collected via a retrospective chart review.

The Role of Liposomal Bupivacaine in Reduction of Postoperative Pain After Transforaminal Lumbar Interbody Fusion: A Clinical Study.

Background: Postoperative pain after transforaminal lumbar interbody fusion (TLIF) is a barrier to early mobility. Intraoperative local infiltration of anesthetic agents is standard practice to alleviate postoperative pain. Liposomal formulations may prolong the action of these anesthetic agents.