Our Summary

This research paper is about a study carried out in Egypt, where doctors performed spine surgery on patients while they were awake, using spinal anesthesia instead of general anesthesia. The study took place during the COVID-19 pandemic and involved 149 patients who needed surgery on their lower back and lower middle back.

The patients ranged in age from 22 to 85, and the surgeries took around 45 to 300 minutes. There were no major heart or lung complications during surgery and patients were able to eat right after surgery. They could also walk without help 6 to 8 hours after surgery. Patients who had two types of surgery, decompression and fusion, were able to leave the hospital 2 or 3 days after their operation.

Patients reported excellent pain relief and were happy with the results of the surgery. Most of the patients were pleased they had been given spinal anesthesia and would recommend it to others. Only one patient had to be switched to general anesthesia because their surgery took too long.

The study concluded that awake spine surgery using spinal anesthesia is safe and results in better outcomes than traditional general anesthesia. This approach also proved useful during the pandemic, as it required fewer resources like ventilators, which could be beneficial in developing areas or during health crises.

FAQs

  1. What was the main finding of the study about awake spine surgery carried out in Egypt?
  2. How did the patients respond to the use of spinal anesthesia during the surgery?
  3. Did the use of spinal anesthesia over general anesthesia prove beneficial during the COVID-19 pandemic, and if so, how?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal surgery is to follow post-operative instructions carefully, including physical therapy exercises, to ensure a successful recovery and optimal results. It is also important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended spinal surgery include those with conditions such as herniated discs, spinal stenosis, degenerative disc disease, spinal fractures, spinal deformities (such as scoliosis), spinal tumors, and spinal infections. These conditions can cause severe pain, weakness, numbness, or loss of function in the back, legs, or arms, and may require surgical intervention to alleviate symptoms and improve quality of life. Patients who have not responded to conservative treatments such as physical therapy, medication, or injections may also be candidates for spinal surgery. Additionally, patients with progressive neurological deficits or loss of bowel or bladder control may require urgent surgical intervention to prevent further complications.

Timeline

  • Before surgery: Patients undergo pre-operative assessments, including physical examinations and medical history evaluations. They may also undergo imaging tests such as X-rays or MRIs to determine the extent of the spinal issue. Patients are informed about the surgical procedure, risks, and benefits, and may be asked to stop taking certain medications or to fast before surgery.

  • Day of surgery: Patients arrive at the hospital or surgical center and are prepared for surgery. They may receive medications to help them relax and be taken to the operating room. Anesthesia is administered, either general anesthesia or spinal anesthesia. In the case of awake spine surgery using spinal anesthesia, patients are conscious during the procedure but do not feel pain. The surgery is performed, and patients are monitored closely throughout.

  • After surgery: Patients are taken to a recovery area where they are monitored for any complications. Depending on the type of surgery and individual recovery, patients may be able to eat, walk, and perform basic activities soon after surgery. They may be discharged from the hospital within a few days or need to stay longer for observation. Post-operative care, including pain management, physical therapy, and follow-up appointments, is provided to help patients recover and achieve optimal outcomes.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with awake spine surgery using spinal anesthesia compared to traditional general anesthesia?

  2. How does awake spine surgery using spinal anesthesia affect recovery time and post-operative pain compared to general anesthesia?

  3. What qualifications and experience do you have in performing awake spine surgery using spinal anesthesia?

  4. What type of spinal surgery do I need and why do you recommend awake spine surgery using spinal anesthesia for my specific case?

  5. Can you explain the procedure in detail, including how the spinal anesthesia will be administered and what I can expect during the surgery?

  6. How long will the surgery take and what is the expected length of hospital stay following awake spine surgery using spinal anesthesia?

  7. What are the potential long-term outcomes and benefits of awake spine surgery using spinal anesthesia compared to general anesthesia?

  8. How will awake spine surgery using spinal anesthesia impact my daily activities and quality of life after the surgery?

  9. Are there any specific precautions or guidelines I should follow before and after the surgery to ensure a successful outcome?

  10. Can you provide me with information on any alternative treatment options for my condition and why awake spine surgery using spinal anesthesia is the best choice for me?

Reference

Authors: Khattab MFM, Sykes DAW, Abd-El-Barr MM, Waguia R, Montaser A, Ghamry SE, Elhawary Y. Journal: Neurosurg Focus. 2021 Dec;51(6):E6. doi: 10.3171/2021.9.FOCUS21456. PMID: 34852322