# Spinal Anesthesia After Thoracolumbar Fixation for Scoliosis: A Case Report Emphasizing the Role of Chest X-ray Reassessment

## TL;DR

This case report shows how spinal anesthesia can be safely used in a patient with a history of spinal surgery by reassessing chest X-rays.

## Contribution

The report highlights the use of chest X-ray reassessment for successful spinal anesthesia in a patient with prior thoracolumbar fixation.

## Key findings

- Landmark-based spinal anesthesia was successfully performed using radiographic reassessment.
- The approach avoided the need for ultrasound in a patient with altered anatomy from prior surgery.

## Abstract

Spinal anesthesia (SA) is widely favored for lower limb orthopedic surgeries due to its rapid onset, effectiveness, and lower risk compared to general anesthesia (GA), particularly in patients with comorbidities. Nevertheless, prior spinal surgery presents significant challenges to SA because of deformed anatomy, scarring, and altered surface landmarks.

In this article, we report successful landmark-based SA using radiographic reassessment, without ultrasound, in an elderly patient with multiple comorbidities and previous thoracolumbar fixation for scoliosis who was scheduled for elective total knee arthroplasty.