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Year : 2020  |  Volume : 14  |  Issue : 1  |  Page : 170-172

Anesthetic challenges in a patient with severe thoracolumbar kyphoscoliosis

1 Department of Anaesthesia, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
2 Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India

Correspondence Address:
Dr. Manbir Kaur
Department of Anaesthesia, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar - 143 501, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aer.AER_1_20

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Patients with thoracolumbar kyphoscoliosis present unique challenges to anesthesia. We report an interesting and challenging case of kyphoscoliosis presenting with a displaced right intertrochanteric femur fracture who was planned for spinal anesthesia. However, spinal anesthesia was not successful even with the use of intraoperative fluoroscopy. The patient was again planned for spinal anesthesia the next day after reviewing his preoperative lumbar X-rays, which were suggestive of severe canal stenosis and sclerosis of the spine at L4–L5and L5-S1level thus causing the failure of contrast to spread up. Using appropriate space (L3–L4) after viewing X-ray, successful spinal anesthesia could be given. This report underscores the importance of reviewing the preoperative radiology of the diseased spine by the anesthesiologist to administer an effective and safe spinal anesthesia in such patients.

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