Dr. Stefano Sinicropi, M.D.

Spine surgery is a major procedure, and because of this, doctors oftentimes opt to include a sleep-like state with the help of general anesthesia. The patient is put out and feels nothing during the procedure, but the use of general anesthesia is not without risk and additional care requirements. Because of this, the medical community is always looking to innovate and come up with new procedural techniques to make surgery and recovery safer. Now, more facilities are shifting to awake spine surgery procedures.

Instead of inducing a sleep-like state with general anesthesia, more surgical teams are considering using local anesthesia or spinal anesthesia to carry out the procedure. We take a closer look at local and spinal anesthesia for spine surgery in today’s blog.

Local And Spinal Anesthesia For Spine Surgery

While alternative anesthesia techniques may not be for everyone, for the right patient, it can actually be safer than general anesthesia. The two more popular techniques being pursued are local anesthesia and spinal anesthesia.

• Local Anesthesia – Local anesthesia involves injecting a numbing agent directly into the surgical site, which effectively blocks pain signals in a small but specific area of the spine.
• Spinal Anesthesia – Spinal anesthesia involves injecting a local anesthetic into the fluid-filled space around the spinal cord, which numbs the body from the chest down.

The Benefits Of Local And Spinal Anesthesia

Local and spinal anesthesia may be preferred to general anesthesia for a number of reasons:

• No Need For Breathing Tubes Or Ventilation – Patients who remain awake during the procedure can continue consciously breathing on their own, without the need to have a breathing tube inserted into the windpipe or use mechanical ventilation.
• Cost Savings – A recent study involving 400 patients found that those who underwent spine surgery with spinal anesthesia saved about 10% on medical costs compared to those whose procedures were performed under general anesthesia.
• Reduced Blood Loss – Another study found that patients undergoing spine surgery experienced less blood loss when spinal anesthesia was pursued compared to general anesthesia.
• Quicker Recovery – Because you’re not put out, you’re not going to experience grogginess, nausea or fatigue that is sometimes associated with general anesthesia. This also means you may be able to discharge from the surgical center sooner, again reducing associated medical costs.
• Potential Surgical Complication Risks – Another study found that patients under general anesthesia were more likely to experience drops in blood pressure and slower heart rates during surgery, which can be dangerous if not addressed appropriately.
• Opioid Use During Recovery – The same study into the efficacy of spinal anesthesia versus general anesthesia found that opioid use was significantly lower in the non-general anesthesia group.

Of course, there could be reasonable explanations for some of these benefits. As we noted, undergoing a major spinal procedure under spinal or local anesthesia isn’t right for every patient. More complex surgeries or those being performed on older patients or those with additional health issues may not be an ideal candidate for awake surgery, and these patients may also have an increased risk for issues during the procedure or while recovering. Many patients end up being a better candidate for general anesthesia spine surgery, but for the right patient, awake spine surgery may offer some additional benefits.

To learn more about different types of spinal procedures, or for answers to a specific back issue you’re dealing with, connect with Dr. Sinicropi and the team at Midwest Spine & Brain Institute today at (651) 430-3800.

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