Our Summary

This research study focuses on the effectiveness of spinal anesthesia, compared to general anesthesia, for lumbar spine surgery in elderly patients. The study reviewed data from a series of lumbar spine surgeries performed on patients aged 70 or above under spinal anesthesia over a period of almost two years. The results show that spinal anesthesia can be a safe and effective method for such surgeries. Patients did not experience serious complications like death, stroke, permanent loss of function, or blood clots in the lungs. Moreover, none of the surgeries had to be switched to general anesthesia, and all patients were able to walk either on the day of the surgery or the next morning. The study supports the use of spinal anesthesia, even for patients over 84 years old and for surgeries lasting up to three and a half hours.

FAQs

  1. Is spinal anesthesia safe for lumbar spine surgery in elderly patients?
  2. Can surgeries be switched from spinal to general anesthesia if complications arise?
  3. Can patients walk immediately after undergoing lumbar spine surgery under spinal anesthesia?

Doctor’s Tip

A doctor might tell a patient undergoing spinal surgery to follow post-operative instructions carefully, including proper wound care, pain management, and physical therapy exercises. It is important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support the healing process and prevent future spine issues.

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, and spinal tumors. These conditions can cause symptoms such as back pain, leg pain, numbness, weakness, and difficulty walking. Patients who have not found relief from conservative treatments such as physical therapy, medications, and injections may be candidates for spinal surgery. Additionally, patients who have progressive neurological deficits or severe symptoms that significantly impact their quality of life may also be recommended for spinal surgery. It is important for patients to discuss their individual case with a spine surgeon to determine if surgery is the best treatment option for them.

Timeline

Before spinal surgery:

  • Consultation with a surgeon to discuss the procedure and treatment options
  • Pre-operative tests and evaluations to assess the patient’s overall health and fitness for surgery
  • Education on what to expect before, during, and after the surgery
  • Pre-surgical preparations such as fasting, stopping certain medications, and showering with special antibacterial soap
  • Anesthesia consultation to discuss the type of anesthesia to be used during the surgery

After spinal surgery:

  • Recovery in the post-anesthesia care unit (PACU) immediately after the surgery
  • Monitoring of vital signs and pain management
  • Physical therapy and rehabilitation to help regain strength and mobility
  • Discharge from the hospital once the surgeon and healthcare team determine the patient is ready to go home
  • Follow-up appointments with the surgeon to monitor healing and address any concerns or complications
  • Gradual return to normal activities and daily routine, with restrictions on lifting, bending, and physical activity for a certain period of time.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal anesthesia for lumbar spine surgery in elderly patients?
  2. How does spinal anesthesia compare to general anesthesia in terms of pain management and recovery time?
  3. What factors make a patient a good candidate for spinal anesthesia for lumbar spine surgery?
  4. How will the anesthesia be administered and monitored during the surgery?
  5. What post-operative care and follow-up should be expected after undergoing spinal anesthesia for lumbar spine surgery?
  6. Are there any specific precautions or restrictions that should be followed after undergoing spinal anesthesia for lumbar spine surgery?
  7. What is the success rate of spinal anesthesia for lumbar spine surgery in elderly patients based on previous cases or studies?
  8. How long can the effects of spinal anesthesia last and what are the potential side effects?
  9. How soon can the patient expect to resume normal activities and return to work after undergoing spinal anesthesia for lumbar spine surgery?
  10. Are there any alternative anesthesia options available for lumbar spine surgery and how do they compare to spinal anesthesia in terms of effectiveness and safety?

Reference

Authors: Lessing NL, Edwards CC 2nd, Brown CH 4th, Ledford EC, Dean CL, Lin C, Edwards CC. Journal: Orthopedics. 2017 Mar 1;40(2):e317-e322. doi: 10.3928/01477447-20161219-01. Epub 2016 Dec 28. PMID: 28027388