Original Article

SPINAL ANESTHESIA FOR SPINAL SURGERY: INDICATIONS AND COMPLICATIONS OF SPINAL ANESTHESIA FOR THE PATIENTS WITH DEGENERATIVE SPINAL DISEASE

  • Gözde Bumin AYDIN

J Turk Spinal Surg 2009;20(1):71-82

Spinal anesthesia can be achieved by injecting small dose of local anesthetic solution into the subarachnoid space. Small volume of local anesthetic blocades sensorial and motor nerves of the lower extremity. Spinal anestesia’s properties include rapidity and control of onset and offset of anaesthesia, proven success, minimal side effects, and complications, ease of administration, minimal expense, increased patient satisfaction and early discharge. Spinal anesthesia is an appropriate technique for lumbar lamminectomy, microdiscectomy and other prosedures of lumbar spine. The advantages of spinal anesthesia are the ability of the patient to self-position and guard against position related injuries, less blood loss, less nause and vomiting, less morbidity and less hospitalization and improvements in pain managment.

Even though spinal anesthesia is a relatively straight forward technique in adults with normal spinal curvature and spinal physioanatomy, it can cause complications concerning orthopedic and traumatology surgeons, neurosurgeons and lastly spinal surgeons. On the other hand, performing spinal anesthesia in congenital spinal deformities especially congenital scolliosis or kyphosis, idiopathic scolliosis, posttraumatic, postinfectious and adolescent kyphosis, acquired deformities in the frontal and sagittal planes such as developmental spondiloesthesis and degenerative spinal diseases has great importance due to applicational difficulties and inevitable complications as a result of these inconviniences. In general, in this study spinal anesthesia and especially its applications on spinal surgery are mentioned giving special emphasis on considerations that should be taken when it is used in degenerative spinal diseases.

Keywords: Spinal anestesia, low back pain surgery, spondylolisthesis, degenerative lumbar spinal disease