Anesthesia considerations for patients with special spine considerations including chronic spinal cord injury, spinal dysraphism, and implantable devices

Central neuraxial blocks in the parturient with previous back surgery have traditionally been avoided due to concerns such as increased difficulty, decreased efficacy, and overall increased rates of complications. Recent studies suggest that with appropriate pre-anesthetic evaluation, patient counseling, utilization of appropriate anesthetic technique, and the incorporation of ultrasound imaging, success rates of neuraxial blocks can be improved. With this knowledge, anesthesiology providers can continue to provide safe and effective maternal care, optimize patient satisfaction, and decrease the need for general anesthesia in the event of cesarean delivery.