Our Summary

This research paper investigates the use of spinal anesthesia (SA) in lumbar spine surgery (LSS). Spinal anesthesia is commonly used in childbirth and orthopedic (bone-related) surgery, but not as much in LSS. One reason for this is the perceived difficulty of managing a patient lying on their stomach (prone) under SA.

The researchers looked back at 34 LSS cases performed under SA. They analyzed operating times and any complications that arose, to see how steep the learning curve was for the surgical team.

The results showed that there was no significant learning curve when SA was used in LSS cases by a team already familiar with SA techniques from other procedures. The post-surgery recovery time was also significantly shorter for patients who stayed overnight, compared to those discharged on the same day.

In conclusion, the study suggests that the challenges in adopting SA for LBS may not be as great as previously thought. This could lead to more widespread use of SA in LSS, which could potentially benefit patients in terms of reducing recovery time.

FAQs

  1. What is spinal anesthesia (SA) and why is it not commonly used in lumbar spine surgery (LSS)?
  2. What were the results of the study regarding the use of SA in LSS?
  3. Could the use of SA in LSS potentially reduce patient recovery time?

Doctor’s Tip

A doctor might tell a patient undergoing spinal surgery to ask about the possibility of using spinal anesthesia, as it has been shown to be safe and effective in lumbar spine surgery and may result in a shorter recovery time. It is also important for the patient to follow post-operative instructions carefully to ensure a successful recovery.

Suitable For

Patients who are typically recommended spinal surgery include those with:

  1. Herniated discs: When the soft inner portion of a spinal disc leaks out through a tear in the tough outer layer, it can press on nearby nerves and cause pain, numbness, or weakness in an arm or leg.

  2. Spinal stenosis: This is a narrowing of the spinal canal that can put pressure on the spinal cord and nerves, leading to pain, numbness, or weakness in the legs.

  3. Scoliosis: This is a sideways curvature of the spine that can cause pain and difficulty breathing.

  4. Spinal fractures: These can be caused by trauma or osteoporosis and may require surgical stabilization.

  5. Spinal tumors: These can be benign or malignant growths that may need to be removed to relieve pressure on the spinal cord or nerves.

  6. Degenerative disc disease: This is a condition where the discs between the vertebrae break down, causing pain and decreased mobility.

  7. Failed back surgery syndrome: This is a condition where a previous spinal surgery has not provided relief, and further surgery may be necessary to address ongoing pain or complications.

It is important for patients considering spinal surgery to consult with a spine specialist to determine the most appropriate treatment option based on their specific condition and individual needs.

Timeline

Before spinal surgery, a patient typically undergoes a series of diagnostic tests, consultations with surgeons and anesthesiologists, and pre-operative preparations such as fasting and medication adjustments. On the day of surgery, the patient is admitted to the hospital, undergoes pre-operative procedures, and is taken to the operating room for the surgery.

During spinal surgery, the patient is placed under general anesthesia or spinal anesthesia, depending on the specific procedure. The surgery itself can last anywhere from a few hours to several hours, depending on the complexity of the case. After the surgery is completed, the patient is taken to the recovery room for monitoring before being transferred to a hospital room or discharged home.

After spinal surgery, the patient typically experiences pain and discomfort at the surgical site, which is managed through medication and physical therapy. The patient may need to stay in the hospital for a few days for monitoring and rehabilitation before being discharged home. Follow-up appointments with the surgeon and physical therapist are scheduled to monitor the patient’s progress and ensure proper healing.

Overall, the timeline for a patient before and after spinal surgery can vary depending on the specific procedure and the individual patient’s recovery process. It is important for patients to follow their surgeon’s instructions and attend all follow-up appointments to ensure a successful recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal surgery include:

  1. What are the potential risks and complications associated with spinal surgery?
  2. What are the expected outcomes and recovery time for this specific surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What is the success rate of this type of surgery for my condition?
  5. Are there any alternative treatment options to consider before undergoing surgery?
  6. How experienced is the surgical team in performing this specific type of spinal surgery?
  7. What type of anesthesia will be used during the surgery and what are the potential side effects?
  8. Will I need to stay overnight in the hospital after the surgery or can I go home the same day?
  9. How long will I need to take off work or limit my activities following the surgery?
  10. Are there any specific instructions or precautions I need to follow before and after the surgery to ensure a successful outcome?

Reference

Authors: West JL, De Biase G, Bydon M, Bojaxhi E, Mendhi M, Quiñones-Hinojosa A, Abode-Iyamah K. Journal: World Neurosurg. 2022 Feb;158:e310-e316. doi: 10.1016/j.wneu.2021.10.172. Epub 2021 Nov 1. PMID: 34737101