Regional Anesthesia for Lumbar Spine Surgery: Can It Be a Standard in the Future?

Lee, Jae Koo; Park, Jong Hwa; Hyun, Seung-Jae; Hodel, D.; Hausmann, Oliver

doi:10.14245/ns.2142584.292

Cited by 28 publications

(28 citation statements)

References 54 publications

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“…[21][22][23] Through reciprocal changes, the thoracolumbar spine can compensate for malalignment, but it leads to further pain and disability. [24][25][26][27] Similar results were obtained in the current study. The forward-shifting of the head correlates with anterior-shifting of the GL (GL-C2, r = -0.71, p < 0.01 and GL-C7, r = -0.52, p < 0.01), and the correlation between VASn score and GL-C2 (r = 0.35, p < 0.05) indicates increasing neck pain as the head shifts forward.…”

Section: Discussionsupporting

confidence: 89%

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Clinical Impact and Correlations of Odontoid Parameters Following Multilevel Posterior Cervical Fusion Surgery

et al. 2022

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Objective: C2 slope (C2S), a cervical parameter mathematically approximated as T1 slope minus cervical lordosis (T1S–CL), predicts functional improvement in cervical deformity patients. Nonetheless, C2S is a positional parameter based only on the horizontal axis. The current study aims to introduce novel odontoid parameters and establish their relationships with patient-reported health-related quality of life (HRQoL).Methods: Lateral plain radiographs of 32 adults who underwent multilevel posterior cervical fusion were analyzed. The odontoid parameters included odontoid incidence (OI), C2S, odontoid tilt (OT), and gravity line-C2 distance (GL-C2), while the cervical parameters were the Cobb angle at C0–1, C1–2, C0–2, C2–7, C2–7 sagittal vertical axis (cSVA), T1 slope, and T1S–CL. The range of motion (ROM) of the occipito-atlantoaxial complex was measured in flexion and extension plain radiographs. Scores on the Neck Disability Index (NDI) and visual analogue scale (VAS) for axial neck (VASn) and arm pain were measured.Results: Compared to asymptomatic subjects, patients had larger C2S, cSVA, and T1S–CL, and smaller OT. Preoperatively, OI was significantly correlated with the ROM of C1–2 (r = 0.37, p < 0.05) and C0–2 (r = 0.46, p < 0.01). OT and C2S had significant correlations with the C0–1, C1–2, and C0–2 angles, GL-C2, and T1S–CL. Postoperative NDI scores were significantly correlated with OI (r = -0.40, p < 0.05) and OT (ρ = -0.37, p < 0.05). VASn was significantly correlated with GL-C2 (r = -0.35, p < 0.05).Conclusion: The odontoid parameters were significantly correlated with established cervical parameters and HRQoL measures. OI is a constant parameter representing the individual's compensatory reservoir at the upper cervical spine.

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Section: Discussionsupporting

confidence: 89%

“…4 ) [ 21 - 23 ]. Through reciprocal changes, the thoracolumbar spine can compensate for malalignment, but it leads to further pain and disability [ 24 - 27 ]. Similar results were obtained in the current study.…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact and Correlations of Odontoid Parameters Following Multilevel Posterior Cervical Fusion Surgery

et al. 2022

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“…Furthermore, the effect of sympathectomy depends on the height of the block. In the spinal cord, 2-6 dermatomes are above the level of sensory block, while the blockage often occurs at the same level in the epidural (18).…”

Section: Local Anesthetics For Spinal Analgesiamentioning

confidence: 99%

Regional Anesthesia Subarachnoid Blockade (RASAB) in Scoliosis Patients

Setijanto

Putra²

2023

IJAR

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Introduction: Scoliosis is a three-dimensional spinal deformity that is mainly determined based on the lateral curvature of the spine. Furthermore, regional anesthesia often infiltrates the peripheral nerves with an anesthetic agent and blocks transmission to avoid or relieve pain. A previous study revealed that scoliosis in patients is one of the factors affecting the success of spinal anesthesia. Objective: To obtain a theoretical basis that can support the solution to the RASAB problem. The acceptance of the theory is the first step to providing a better understanding of the study problem based on the scientific framework of thinking. Furthermore, the similarities, differences, and views of several pieces of literature that discussed related issues were evaluated in this review. Review: Regional anesthesia subarachnoid blockade (RASAB) or spinal anesthesia, is a procedure, which involves the administration of local anesthetic drugs into the subarachnoid space. Furthermore, the process is carried out between the lumbar (L) vertebrae L2-L3, L3-L4, or L4-L5. Spinal anesthesia is often used in surgical procedures involving the lower abdomen, pelvis, perineum, and lower extremities. Summary: In the setting of scoliosis, spinal anesthesia is challenging, but is not an absolute contraindication. Patients with scoliosis have unique characteristics, hence, anesthetists need to understand the impact of the disease on the body.

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“…However, this approach is unsuitable for operations involving the thoracic and cervical spine and may hinder early postoperative neurological assessment. Use of regional anesthesia in spine surgery also requires the patient to maintain a prone position for extended periods, making it unsuitable for longer procedures [ 29 , 31 ].…”

Section: Approaches To Managing Bleeding In Spine Surgerymentioning

confidence: 99%

Hemostats in Spine Surgery: Literature Review and Expert Panel Recommendations

et al. 2022

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Bleeding in spine surgery is a common occurrence but when bleeding is uncontrolled the consequences can be severe due to the potential for spinal cord compression and damage to the central nervous system. There are many factors that influence bleeding during spine surgery including patient factors and those related to the type of surgery and the surgical approach to bleeding. There are a range of methods that can be employed to both reduce the risk of bleeding and achieve hemostasis, one of which is the adjunct use of hemostatic agents. Hemostatic agents are available in a variety of forms and materials and with considerable variation in cost, but specific evidence to support their use in spine surgery is sparse. A literature review was conducted to identify the pre-, peri-, and postsurgical considerations around bleeding in spine surgery. The review generated a set of recommendations that were discussed and ratified by a wider expert group of spine surgeons. The results are intended to provide a practical guide to the selection of hemostats for specific bleeding situations that may be encountered in spine surgery.

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Regional Anesthesia for Lumbar Spine Surgery: Can It Be a Standard in the Future?

Cited by 28 publications

References 54 publications

Clinical Impact and Correlations of Odontoid Parameters Following Multilevel Posterior Cervical Fusion Surgery

Clinical Impact and Correlations of Odontoid Parameters Following Multilevel Posterior Cervical Fusion Surgery

Regional Anesthesia Subarachnoid Blockade (RASAB) in Scoliosis Patients

Hemostats in Spine Surgery: Literature Review and Expert Panel Recommendations

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