Spinal Versus General Anesthesia for Lumbar Decompression or Sequestrectomy in Patients Over 75 Years

Area of Science:

• Neurosurgery
• Anesthesiology
• Geriatric Medicine

Background:

• Lumbar decompression and sequestrectomy procedures can be performed under general anesthesia (GA) or regional anesthesia.
• The optimal anesthetic choice for elderly patients undergoing these procedures remains unclear.

Purpose of the Study:

• To evaluate the safety and efficacy of spinal anesthesia (SA) compared to GA for lumbar decompression or sequestrectomy in patients over 75 years old.

Main Methods:

• Retrospective single-center study including 154 patients (mean age 81 years) who underwent lumbar decompression or sequestrectomy.
• Data on perioperative outcomes (blood loss, dural tear, operative time, delirium, urinary retention, hospital stay) and 1-year postoperative follow-up (pain scores, complications) were collected and compared between GA and SA groups.

Main Results:

• Spinal anesthesia (SA) was administered to 56 patients, while 98 received general anesthesia (GA).
• No significant clinical differences in complication rates were observed between the SA and GA groups.
• Patients undergoing SA experienced significantly shorter surgery times, reduced blood loss, and shorter hospital stays.

Conclusions:

• Both spinal anesthesia (SA) and general anesthesia (GA) are safe and reliable anesthetic options for elderly patients undergoing lumbar decompression or sequestrectomy.
• Spinal anesthesia may offer advantages in terms of reduced operative and hospital stay times.