Complex Lumbar Spine Fusion for an Elderly Patient Under Spinal Anesthesia

Spinal anesthesia for spine surgery is an emerging technique. Because of their lack of physiologic reserve, elderly patients are an appealing population for this technique. Unfortunately, the safe limits of spine surgery using spinal anesthesia for the geriatric population are not well defined. The authors describe an elderly patient with severe spine degeneration who elected for a 5-level lumbar spine fusion with spinal anesthesia. Adequate anesthesia was maintained throughout the procedure, which lasted 3 hours and 24 minutes. The patient experienced no perioperative complications. To the authors' knowledge, this is one of the longest spine surgeries using spinal anesthesia. Also, the fusion procedure spans more vertebral levels than previously reported. Further investigation is needed to determine the safety of this technique. [Orthopedics. 2017; 40(5):e915-e917.].