• Gaetano De Biase, Shaun E Gruenbaum, Alfredo Quiñones-Hinojosa, and Kingsley O Abode-Iyamah.
• Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA.
• Neurosurgery. 2022 Feb 1; 90 (2): 186191186-191.

BackgroundThere has recently been increasing interest in the use of spinal anesthesia (SA) for spine surgery. The literature that compared spine surgery under SA vs general anesthesia (GA) focused on safety, perioperative outcomes, and costs.ObjectiveTo test if SA is associated with less postoperative fatigue, cognitive dysfunction, and better quality of life in patients undergoing lumbar spine surgery compared with GA.MethodsWe conducted a prospective nonrandomized study in patients undergoing elective lumbar spine surgery under SA or GA by a single surgeon. Fatigue was assessed with the fatigue visual analog scale scale (0-10) and Chalder Fatigue Scale, quality of life with Medical Outcomes Study 12-item Short Form (SF-12), and differences in cognition with Mini-Mental State Examination. Patients were baselined before surgery and assessed again 1 mo after surgery.ResultsFifty patients completed the study, 25 underwent surgery under SA and 25 under GA. The groups were homogeneous for baseline clinical characteristics, with no differences in preoperative fatigue, quality of life, and cognition. At 1 mo after surgery, SA compared with GA had better fatigue scores: fatigue visual analog scale (2.9 ± 1.5 vs 5.9 ± 2.3 [P < .0001]) and Chalder Fatigue Scale (11.2 ± 3.1 vs 16.9 ± 3.9 [P < .0001]). One month postoperatively, we observed a significant difference in the SF-12 physical component, with SA having 38.8 ± 8.9 vs 29.4 ± 10.3 (P = .002). We did not observe significant postoperative differences in the SF-12 mental component or Mini-Mental State Examination.ConclusionOur study demonstrates that SA offers unique patient-centered advantages to GA for elective spine surgery. One month after surgery, patients who received SA had less postoperative fatigue and better quality of life.Copyright © Congress of Neurological Surgeons 2021. All rights reserved.

22 keywords...

hide…