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Spinal Versus General Anesthesia for Spine Surgery During the COVID-19 Pandemic: A Case Series – Lumbar Fusion

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The article discusses the use of spinal anesthesia (SA) as an alternative to general anesthesia for patients undergoing discectomy surgery for lumbar spinal disc herniation during the COVID-19 pandemic. Due to the risk of disease transmission in hospitals, many guidelines recommended postponing elective spine surgeries. The study retrospectively analyzed 64 patients who underwent lumbar discectomy with SA. The majority of patients were male, and the mean procedure time for SA was 10 minutes. The surgery duration ranged from 40 to 90 minutes per level of disc herniation. The patients had a mean recovery time of 20 minutes and experienced good pain relief. All patients were discharged a day after surgery, and there were no recurrence symptoms or negative memories of the surgery during the six-month follow-up. The study concludes that SA is a viable option for patients with lumbar disc herniation, but further research is needed to determine the best candidates for SA in patients with lumbar pathology

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised day surgery spinal centre in UK

Published article

CONCLUSIONS: Spinal anesthesia is a good alternative or even the main anesthesia route for patients with lumbar disc herniation. More studies are needed to elucidate the best candidate for SA in patients with lumbar pathology.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Anesth Pain Med. 2023 Mar 29;13(2):e134783. doi: 10.5812/aapm-134783. eCollection 2023 Apr.ABSTRACTBACKGROUND: Hospitals are one of the primary resources for disease transmission, so many guidelines were published, and neurosurgeons were advised to postpone elective spine surgeries during the COVID-19 pandemic.OBJECTIVES: To avoid pulmonary complications and reduce the risk of spreading the virus and contracting the disease,

Anesth Pain Med. 2023 Mar 29;13(2):e134783. doi: 10.5812/aapm-134783. eCollection 2023 Apr.

ABSTRACT

BACKGROUND: Hospitals are one of the primary resources for disease transmission, so many guidelines were published, and neurosurgeons were advised to postpone elective spine surgeries during the COVID-19 pandemic.

OBJECTIVES: To avoid pulmonary complications and reduce the risk of spreading the virus and contracting the disease during the COVID-19 era, we operated a group of our patients under spinal anesthesia rather than general anesthesia.

METHODS: We retrospectively analyzed all patients who underwent discectomy surgery for lumbar spinal disc herniation under SA between September 2020 and 2021.

RESULTS: Sixty-four patients diagnosed with lumbar disc herniation underwent lumbar discectomy with SA. All patients except three were male. The mean age was 44.52 ± 7.95 years (28 to 64 years). The mean procedure time for SA was 10 minutes. The duration of the surgery was 40 to 90 minutes per each level of disc herniation. The mean blood loss was 350 cc (200 to 600 cc). The most common involved level was L4/L5 intervertebral disc (n = 40 patients; 63.5%). The mean recovery time was 20 minutes. Only three patients requested more analgesics for relief of their pain postoperatively. All patients with discectomy were discharged a day after surgery, and in the case of fusion, two days after surgery. All the patients were followed up for six months, showing no recurrence symptoms, good pain relief, satisfaction with the surgery, and no bad memory of the surgery.

CONCLUSIONS: Spinal anesthesia is a good alternative or even the main anesthesia route for patients with lumbar disc herniation. More studies are needed to elucidate the best candidate for SA in patients with lumbar pathology.

PMID:37601956 | PMC:PMC10439686 | DOI:10.5812/aapm-134783

The London Spine Unit : most specialised day surgery spinal centre in UK

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Spinal Versus General Anesthesia for Spine Surgery During the COVID-19 Pandemic: A Case Series

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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Anesth Pain Med. 2023 Mar 29;13(2):e134783. doi: 10.5812/aapm-134783. eCollection 2023 Apr.ABSTRACTBACKGROUND: Hospitals are one of the primary resources for disease transmission, so many guidelines were published, and neurosurgeons were advised to postpone elective spine surgeries during the COVID-19 pandemic.OBJECTIVES: To avoid pulmonary complications and reduce the risk of spreading the virus and contracting the disease

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