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Spinal Anesthesia in Elderly Patients Undergoing Lumbar Spine Surgery
Orthopedics
|December 28, 2016
Summary
Spinal anesthesia is a safe and effective option for elderly patients undergoing lumbar spine surgery, including those over 84 years old. This method demonstrated good outcomes with no major complications, allowing patients to ambulate quickly post-surgery.
Area of Science:
- Anesthesiology
- Neurosurgery
- Geriatric Medicine
Background:
- Spinal anesthesia is a viable alternative to general anesthesia for lumbar spine procedures.
- Limited data exists on spinal anesthesia outcomes in elderly patients undergoing lumbar decompression or fusion.
Purpose of the Study:
- To evaluate the safety and efficacy of spinal anesthesia in patients aged 70 and older undergoing lumbar spine surgery.
- To report single-institution experience with this patient population.
Main Methods:
- Retrospective review of a prospectively collected database.
- Analysis of 56 consecutive patients (≥70 years) undergoing lumbar spine surgery under spinal anesthesia (Dec 2013-Oct 2015).
- Procedures included decompression (48%) and combined decompression/fusion (52%).
Main Results:
- Mean operative time: 101 minutes; mean blood loss: 187 mL.
- Postoperative pain scores averaged 6.2/10; nausea occurred in 21%.
- No mortality, stroke, permanent dysfunction, or pulmonary embolism; all patients ambulated day of or day after surgery.
Conclusions:
- Spinal anesthesia is a safe and effective anesthetic method for elderly patients (≥70 years) undergoing lumbar spine surgery.
- This approach is also safe for patients over 84 years and for surgeries up to 3.5 hours.
- No conversions to general anesthesia were required, and all patients achieved early ambulation.
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