Should Spinal Anesthesia Be Used for Spine Surgery: A Case Report

TL;DR

A patient successfully underwent spine surgery with spinal anesthesia, highlighting the need to critically evaluate supporting literature.

Contribution

Highlights potential issues with relying on outdated or flawed research in anesthesia decision-making.

Findings

Spinal anesthesia was successfully used for lumbar spine surgery without complications.

Nine recent reviews favor spinal over general anesthesia but rely on flawed older studies.

Blind reliance on review conclusions may lead to misleading clinical decisions.

Abstract

A patient with lumbar spine stenosis presented for lumbar spine decompression, clearly stating a preference for spinal anesthesia (SA) over general anesthesia (GA). Surgery was performed under uneventful SA without sedation. The patient recovered from surgery quickly and without incident, requiring no postoperative opioid analgesia. What data support administering SA for lumbar spine surgery? A literature search found nine recently published reviews favoring SA over GA. These reviews cited many of the same, older, flawed, primary research reports. Although choosing SA was reasonable, our literature analysis suggests blind reliance on summary conclusions of reviews and meta-analyses may be misleading.