RT Journal Article SR Electronic T1 Spinal Anesthesia for Geriatric Lumbar Spine Surgery: A Comparative Case Series JF International Journal of Spine Surgery JO Int J Spine Surg FD International Society for the Advancement of Spine Surgery SP 713 OP 721 DO 10.14444/7103 VO 14 IS 5 A1 NOAH L. LESSING A1 CHARLES C. EDWARDS II A1 CLAYTON L. DEAN A1 OLIVE H. WAXTER A1 CHARLES LIN A1 RYAN A. CURTO A1 CHARLES H. BROWN IV YR 2020 UL http://ijssurgery.com//content/14/5/713.abstract AB Background: The use of spinal anesthesia (SA) as opposed to general anesthesia (GA) during elective lumbar spine surgery is an emerging technique and represents a potentially modifiable factor to limit perioperative complications. Few studies, however, have compared these anesthetic techniques in an elderly population. The aim of this study is to determine if SA is a safe alternative to GA for lumbar spine surgery in elderly patients.Methods: A retrospective, consecutive case series study was performed. All patients aged 70 years and older who underwent lumbar spine decompression or combined decompression and fusion using either SA or GA during a 2-year period at a single institution were identified. Demographics and perioperative outcomes were compared.Results: Of all patients meeting the inclusion criteria, 56 patients (19%) received SA and 239 (81%) received GA. Patients receiving SA were slightly older (median age, 77 years versus 75 years, P = .002), consisted of more men (57% versus 36%, P = .01), and had a lower mean body mass index (28.3 versus 30.1, P = .03). Indications for surgery and type of surgery were similar between groups. On average, operative times with SA were 101 minutes versus 103 minutes with GA (P = .71). After controlling for age, sex, and body mass index, patients receiving SA had decreased estimated blood loss (β = −75 mL; 95% confidence interval [CI], −140.6, −9.4; P = .025) and intraoperative intravenous fluid requirements (β = −205 mL; 95% CI, −389.4, −21.0; P = .029), shorter postanesthesia care unit stays (β = −41 minutes; 95% CI, −64.6, −16.9; P = .001), lower maximum visual analog scale pain scores (β = −0.89 points; 95% CI, −1.6, −0.1; P = .020), and decreased odds of receiving blood transfusion (odds ratio, 0.12; 95% CI, 0.01, 0.62; P = .45); there were no significant differences in operative time, length of stay, nausea, or oral morphine equivalents consumed per day. Complication rates were similar between groups.Conclusion: Spinal anesthesia is a reasonable, safe alternative to general anesthesia for lumbar spine surgery in elderly patients with degenerative conditions.