ABSTRACT
Background:
Lower back pain is a common problem in society leading to a decrease in work forces. Clinical studies indicate that the source of back pain is intervertebral disc and lumbar stenosis. Surgery for lumbar disc and lumbar stenosis can be performed under general or local anesthesia. In this study, we aimed retrospectively examination lumbar disc and lumbar stenosis patients, operated under SA, and evaluate advantages and disadvantages of this technique.
Methods:
Two hundred twenty two patients who were operated for lumbar disc herniation (LDH) and lumbar stenosis (LS) under SA between March 2012 and September 2013 were included in this study. Clinical data, neurological examination, additional diseases, VAS scores, operation duration, intraoperative complication, first ambulation time, postoperative headache and hospital stay durations were collected for statistical analysis.
Results:
Ninety-four (42.3 %) patients were male, and 128 (57.7 %) were female. Mean age of the males and females were 47.6 and 48 years, respectively (p=0.74). Most frequent operation technique was hemipartial laminectomy and microdiscectomy (73.9 %), followed by HPL and foraminotomy (25.2 %). Comparisons between males and females revealed operation type (p=0.39), diagnosis (p=0.17), and localization (p=0.25) not to be statistically significant between genders. There was statistically significant decrease in the VAS scores immediately after surgery (p<0.001). 7 (3%) patients needed additional intraoperative anesthetic. 8 (3.6 %) patients experienced hypotension and nausea during surgery. 153 (68.9 %) patient did not suffer from postoperative headache, while 11 (4.9 %) patient had severe headache.
Conclusion:
Our study also supports spinal anesthesia in elective lumbar surgeries to decrease the surgical procedure time, loss of blood, earlier postoperative mobilization and oral feeding. However, disadvantages include post-op headache and the hypotension due to spinal anesthesia level getting higher, nausea and vomiting. In well-selected cases, the effectiveness of spinal anesthesia is proven high.