The use of ultrasound to facilitate spinal anesthesia in a patient with previous lumbar laminectomy and fusion: a case report.
We describe a case of ultrasound (US)-facilitated spinal anesthesia in a patient with a prior lumbar laminectomy and spinal fusion who presented for total knee arthroplasty. Traditional, landmark-guided spinal anesthesia had previously failed. Although pre-procedural US identified a soft-tissue window at L3/4, a 25G pencilpoint needle encountered resistance. Reassured from US imaging that this was not bone, we used a 22G cutting tip needle successfully. We believe spinal anesthesia would not have been possible in this patient without US, adding to the evidence that US-facilitated neuraxial anesthesia is useful, particularly in technically difficult, if not 'impossible,' cases.
Chin
Ki Jinn
KJ
Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Ontario, Canada.
Macfarlane
Alan J R
AJ
Chan
Vincent
V
Brull
Richard
R
D000775:Anesthesia, Spinal / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D006801:Humans; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D015203:Reproducibility of Results; D013123:Spinal Fusion; D013346:Subarachnoid Space / Q000000981:diagnostic imaging*; D014463:Ultrasonography