Lengthy complex lumbar fusion surgery in high-risk elderly patient under spinal anesthesia: A case report

Ryan A. Curto, Charles C. Edwards, Charles Lin, Charles H. Brown

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Spinal Anesthesia (SA) continues to be an emerging technique for lumbar fusion surgery in the elderly population. SA is an appealing option in the high-risk geriatric population for several reasons, including the potential for reduced systematic stress, reduced blood loss, and reduced post-operative delirium. The safe limits of spine surgery under SA remain undetermined. Presentation of case: The following case-study describes an elderly high-risk patient (ASA III) with severe spinal stenosis and degenerative scoliosis who presented with lower back and right leg pain and underwent a 3-level lumbar fusion surgery with spinal anesthesia. The procedure lasted 3 h and 44 min with sufficient anesthesia maintained throughout. The patient experienced minor post-operative complications, but had an excellent clinical outcome at 3-month follow-up. Discussion: Further research should be conducted to define the temporal limits of SA in elderly patients and the etiology of post-operative complications following lumbar fusion surgery under spinal anesthesia in the geriatric population. Conclusion: The case reported, herein, demonstrates the feasibility of SA in elderly patients undergoing lengthy complex lumbar surgeries who have been designated “high-risk” patients (ASA > II) and provides support for future investigation into surgical and anesthesia treatment options for geriatric high-risk patients presenting with complex lumbar spine pathologies.

Original languageEnglish (US)
Pages (from-to)131-134
Number of pages4
JournalInternational Journal of Surgery Case Reports
Volume65
DOIs
StatePublished - 2019

Keywords

  • Case report
  • Geriatric
  • Lumbar fusion
  • Spinal anesthesia
  • Spine surgery

ASJC Scopus subject areas

  • Surgery

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