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Anesthesia practice among joint arthroplasty patients with a previous lumbar spine surgery – Lumbar Fusion

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The article, published in the Journal of Clinical Anesthesia, examines the use of neuraxial techniques in total hip or knee arthroplasty patients who have previously undergone lumbar spine surgeries. The study is a retrospective analysis of a national database, including patients from U.S. hospitals. The primary outcome measured was the use of neuraxial anesthesia, with secondary outcomes including complications and length of stay. The results showed that patients with a history of lumbar fusion had lower odds of receiving neuraxial anesthesia compared to those without a lumbar procedure. However, the use of neuraxial anesthesia was still associated with a decreased length of stay. The authors conclude that more research is needed to understand the importance of neuraxial techniques in patients with prior spine surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: Previous lumbar fusion -but not decompression- surgery is associated with lower neuraxial anesthesia in THA/TKA patients, despite its use being universally associated with decreased length of stay. More research is needed to address the importance of neuraxial techniques in patients with prior spine surgery.

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J Clin Anesth. 2023 Jul 25;90:111222. doi: 10.1016/j.jclinane.2023.111222. Online ahead of print.ABSTRACTSTUDY OBJECTIVE: To analyze the use of neuraxial techniques in total hip or knee arthroplasty patients who previously underwent lumbar spine surgeries.DESIGN: Retrospective analysis of a national database.SETTING: U.S. hospitals.PATIENTS: Patients undergoing a total hip or knee arthroplasty, stratified by those with a previous,

J Clin Anesth. 2023 Jul 25;90:111222. doi: 10.1016/j.jclinane.2023.111222. Online ahead of print.

ABSTRACT

STUDY OBJECTIVE: To analyze the use of neuraxial techniques in total hip or knee arthroplasty patients who previously underwent lumbar spine surgeries.

DESIGN: Retrospective analysis of a national database.

SETTING: U.S. hospitals.

PATIENTS: Patients undergoing a total hip or knee arthroplasty, stratified by those with a previous lumbar fusion or decompression procedure.

MEASUREMENTS: Our primary outcome was the use of neuraxial anesthesia; secondary outcomes included combined complications, cardio-pulmonary complications, and prolonged length of stay. Patients with and without a history of a lumbar procedure were compared using mixed-effects regression.

MAIN RESULTS: Among 758,857 THAs 8961 had a history of lumbar fusion and 8599 of decompression. Among 1,387,335 TKAs 15,827 had a history of lumbar fusion and 13,652 of decompression. History of a lumbar fusion was associated with lower odds of neuraxial anesthesia use in THA (OR: 0.74 CI: 0.70-0.79, p ≤0.0001) and TKA (OR: 0.80 CI: 0.77-0.84, p ≤0.0001).

CONCLUSIONS: Previous lumbar fusion -but not decompression- surgery is associated with lower neuraxial anesthesia in THA/TKA patients, despite its use being universally associated with decreased length of stay. More research is needed to address the importance of neuraxial techniques in patients with prior spine surgery.

PMID:37499315 | DOI:10.1016/j.jclinane.2023.111222

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Anesthesia practice among joint arthroplasty patients with a previous lumbar spine surgery

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J Clin Anesth. 2023 Jul 25;90:111222. doi: 10.1016/j.jclinane.2023.111222. Online ahead of print.ABSTRACTSTUDY OBJECTIVE: To analyze the use of neuraxial techniques in total hip or knee arthroplasty patients who previously underwent lumbar spine surgeries.DESIGN: Retrospective analysis of a national database.SETTING: U.S. hospitals.PATIENTS: Patients undergoing a total hip or knee arthroplasty, stratified by those with a previous
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