Posterior lumbar stabilization surgery under spinal anesthesia for high-risk patients with degenerative spondylolisthesis, spinal stenosis and lumbar compression fracture
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AIm: Spinal anesthesia is an appropriate technique for lumbar spine surgeries of two to three hours duration. The aim of this study is todocument our experience on spinal anesthesia administered to the patients with degenerative lumbar spine.Ma terIal and Methods: A total of 497 patients underwent spinal stabilization surgery with spinal anesthesia for degenerative lumbarspinal disorders in an 8-year period. Spinal anesthesia was performed at the L3-L4 or L4-L5 level and subarachnoid block was achieved with15 mg of 0.5% plain bupivacaine with 2 µg of fentanyl and 0.2 mg of epinephrine. There was no failure of anesthesia. The patients wereclosely monitored for complications associated with the SA technique and especially hypotension and bradycardia but no gross alterations incardiovascular stability were noted.Results: Among the 497 patients, 139 were male and 358 were female with a median age of 51 years. The average anesthesia durationwas 130 minutes and the average operative time was 85 minutes. In the postoperative period 36 patients has nausea (7.2%) and 18 of themhad vomiting (3.6%) that required one dose of antiemetic. No spinal headache was observed and 36 (7.2%) patients complained of urinaryretention. All recovered with urinary cannulation within 24 hours. No respiratory complication occurred and no patient died.ConclusIon: Spinal anesthesia is a safe and effective procedure for the lumbar spinal stabilization surgery, especially in high-riskpatients.Proper precautions should be taken in order to achieve an effective anesthesia for these operations.