Publication:

Vertebral body changes that make spinal anesthesia difficult in geriatric patients

Spinal anaesthesia techniques are important, because age-related structural and degenerative alterations to the spine sometimes make it difficult to deliver spinal anaesthesia to the elderly population. The current understanding of age-related changes in the vertebral column that affect successful administration of spinal anaesthesia is thoroughly examined in this review. Our review focuses on the adverse effects of osteoporotic degenerative changes in older individuals, including reduced disc height, calcified ligaments, osteophyte formation, and narrowed interspinous spaces. These changes collectively complicate landmark identification and needle insertion and increase the risk of traumatic or failed spinal anaesthesia. Even though spinal anaesthesia is frequently a better option for older patients than general anaesthesia, age-related anatomical changes in the vertebral column present serious technical difficulties that can result in block failure and potentially requiring alternative or adapted approaches. The effectiveness of a number of adaptive techniques, including paramedian approaches, ultrasound-guided neuraxial blocks, and the use of alternate access sites in the sacral or lower lumbar spine, is analyzed further in this review. This review article additionally examines the challenges of delivering spinal anaesthesia to geriatric patients with altered spine structure, and investigates future directions in this field and notes a few limitations.