Public Health and Primary CareCase Report

Osteopathic Musculoskeletal Examination and Subarachnoid Anesthetic Administration in a Patient With Severe Scoliosis

James J. Lamberg, DO; Sanjib D. Adhikary, MB; and Andrew T. McFadden, DO
Notes and Affiliations
Notes and Affiliations

Received: October 7, 2013

Accepted: January 16, 2014

Published: July 1, 2014

J Osteopath Med; 114(7): 582-585

Physicians primarily use palpation of anatomical landmarks to guide the placement of needles when administering neuraxial anesthetics. For patients with anatomical abnormalities such as scoliosis, it is also important for physicians to understand Fryette mechanics and spinal curvature anatomy, as well as preprocedural radiography and ultrasonography, to ensure accuracy in neuraxial anesthetic procedures. The authors report the case of a patient with severe scoliosis who required neuraxial anesthesia for total hip arthroplasty. Using palpation and imaging, his physicians were able to successfully administer a subarachnoid anesthetic injection on the first attempt. The authors discuss considerations for improving success rates of neuraxial anesthetic administration in these patients.

Read Full Article