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Updated: Oct 13, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Complicated Neuraxial Anesthesia in a Patient With Tethered Spinal Cord
Eitan A Scher1, Sabry Ayad1,2,3
1Outcomes Research, Cleveland Clinic, Cleveland, USA.
Abstract:
Spinal anesthesia is a common anesthetic used in many surgical procedures. Anatomical variations and diseases make this procedure require extra considerations. Extra care should be taken into consideration in the pre-anesthesia evaluation when neuraxial anesthesia is planned. We present the case of a patient undergoing cesarean section for the arrest of labor, who had a complicated labor course due to unrecognized history of a tethered spinal cord leading to inadequate analgesia, requiring replacement of epidural analgesia and spinal anesthesia. Ultimately, the decision was made to proceed with general anesthesia due to the patient's discomfort. Exhaustive chart review after surgery showed a past MRI with evidence of a tethered spinal cord.
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