{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T02:50:49Z","timestamp":1769309449084,"version":"3.49.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2019,10,24]],"date-time":"2019-10-24T00:00:00Z","timestamp":1571875200000},"content-version":"vor","delay-in-days":296,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Spinal Anesthesia (SA) continues to be an emerging technique for lumbar fusion surgery in the elderly population. SA is an appealing option in the high-risk geriatric population for several reasons, including the potential for reduced systematic stress, reduced blood loss, and reduced post-operative delirium. The safe limits of spine surgery under SA remain undetermined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>The following case-study describes an elderly high-risk patient (ASA III) with severe spinal stenosis and degenerative scoliosis who presented with lower back and right leg pain and underwent a 3-level lumbar fusion surgery with spinal anesthesia. The procedure lasted 3 h and 44 min with sufficient anesthesia maintained throughout. The patient experienced minor post-operative complications, but had an excellent clinical outcome at 3-month follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Further research should be conducted to define the temporal limits of SA in elderly patients and the etiology of post-operative complications following lumbar fusion surgery under spinal anesthesia in the geriatric population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The case reported, herein, demonstrates the feasibility of SA in elderly patients undergoing lengthy complex lumbar surgeries who have been designated \u201chigh-risk\u201d patients (ASA &gt; II) and provides support for future investigation into surgical and anesthesia treatment options for geriatric high-risk patients presenting with complex lumbar spine pathologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2019.10.053","type":"journal-article","created":{"date-parts":[[2019,11,3]],"date-time":"2019-11-03T08:40:51Z","timestamp":1572770451000},"page":"131-134","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Lengthy complex lumbar fusion surgery in high-risk elderly patient under spinal anesthesia"],"prefix":"10.1097","volume":"65","author":[{"given":"Ryan A.","family":"Curto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles C.","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles H.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-29-20260114","first-page":"524","article-title":"Spinal anesthesia versus general anesthesia for elective lumbar spine surgery: a randomized clinical trial","volume":"16","author":"Attari","year":"2011","journal-title":"J. Res. Med. Sci"},{"key":"R2-29-20260114","first-page":"771","article-title":"Posterior lumbar stabilization surgery under spinal anaesthesia for patients with degenerative spondylolisthesis, spinal stenosis and lumbar compression fracture","volume":"25","author":"Erbas","year":"2015","journal-title":"Turk. Neurosurg"},{"key":"R3-29-20260114","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/j.1365-2044.2006.04697.x","article-title":"Spinal anaesthesia for spinal surgery","volume":"61","author":"Goddard","year":"2006","journal-title":"Anaesthesia"},{"key":"R4-29-20260114","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1213\/00000539-199609000-00021","article-title":"A prospective randomized study comparing short- and intermediate-term perioperative outcome variables after spinal or general anesthesia for lumbar disk and laminectomy surgery","volume":"83","author":"Jellish","year":"1996","journal-title":"Anesth. Analg"},{"key":"R5-29-20260114","first-page":"167","article-title":"Perioperatvie outcome and cost-effectiveness of spinal versus general anesthesia for lumbar spine surgery","volume":"48","author":"Kahveci","year":"2014","journal-title":"Pol. Neurol. Soc"},{"key":"R6-29-20260114","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3171\/spi.2005.2.1.0017","article-title":"Comparison of spinal and general anesthesia in lumbar laminectomy surgery: a case controlled analysis of 400 patients","volume":"2","author":"McLain","year":"2005","journal-title":"J. Neurosurg. Spine"},{"key":"R7-29-20260114","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/S0952-8180(98)00112-3","article-title":"Spinal anesthesia for elective lumbar spine surgery","volume":"10","author":"Tetzlaff","year":"1998","journal-title":"J. Clin. Anesth"},{"key":"R8-29-20260114","first-page":"e317","article-title":"Spinal anesthesia in elderly patients undergoing lumbar spine surgery","volume":"40","author":"Lessing","year":"2017","journal-title":"Orthopedics"},{"key":"R10-29-20260114","first-page":"e915","article-title":"Complex lumbar spine fusion for an elderly patient under spinal anesthesia","volume":"40","author":"Lessing","year":"2017","journal-title":"Orthopedics"},{"key":"R11-29-20260114","first-page":"175","article-title":"Anesthesia for the elderly","volume":"11","author":"Kanonidou","year":"2007","journal-title":"Hippokratia"},{"key":"R12-29-20260114","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1097\/00000542-200211000-00030","article-title":"Brachial plexus nerve block exhibits prolonged duration in the elderly","volume":"97","author":"Paqueron","year":"2002","journal-title":"Anesthesiology"},{"key":"R13-29-20260114","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1111\/j.1532-5415.2010.02762.x","article-title":"Delirium: an independent predictor of functional decline after cardiac surgery: delirium and function after cardiac surgery","volume":"58","author":"Rudolph","year":"2010","journal-title":"J. Am. Geriatr. Soc"},{"key":"R14-29-20260114","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1097\/ALN.0000000000002253","article-title":"Cognitive decline after delirium in patients undergoing cardiac surgery","volume":"129","author":"Brown","year":"2018","journal-title":"Anesthesiology"},{"key":"R15-29-20260114","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/s40266-017-0455-9","article-title":"The comparative risk of delirium with different opioids: a systematic review","volume":"34","author":"Swart","year":"2017","journal-title":"Drugs Aging"},{"key":"R16-29-20260114","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4065\/mcp.2009.0469","article-title":"Sedation depth during spinal anesthesia and the development of postoperative delirium in elderly patients undergoing hip fracture repair","volume":"85","author":"Sieber","year":"2010","journal-title":"Mayo Clin. Proc"},{"key":"R17-29-20260114","doi-asserted-by":"crossref","first-page":"i98","DOI":"10.1093\/bja\/aet055","article-title":"Monitoring depth of anaesthesia in a randomized trial decreases the rate of postoperative delirium but not postoperative cognitive dysfunction","volume":"110","author":"Radtke","year":"2013","journal-title":"Br. J. Anaesth"},{"key":"R18-29-20260114","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/ANA.0b013e3182712fba","article-title":"BIS-guided anesthesia decreases postoperative delirium and cognitive decline","volume":"25","author":"Chan","year":"2013","journal-title":"J. Neurosurg. Anesthesiol"},{"key":"R19-29-20260114","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1001\/jamasurg.2018.2602","article-title":"Effect of depth of sedation in older patients undergoing hip fracture repair on postoperative delirium: the STRIDE randomized clinical trial","volume":"153","author":"Sieber","year":"2018","journal-title":"JAMA Surg"},{"key":"R20-29-20260114","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jclinane.2018.01.004","article-title":"Spinal versus general anesthesia for lumbar spine surgery in high risk patients: perioperative hemodynamic stability, complications and costs","volume":"46","author":"Finsterwald","year":"2018","journal-title":"J. Clin. Anesth"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261219305991?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261219305991?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01612930-201965000-00029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:03:00Z","timestamp":1768395780000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01612930-201965000-00029"}},"subtitle":["A case report"],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":19,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2019.10.053","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2019,1]]}}}