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She was diagnosed with oxygen-requiring pneumonia and bilateral popliteal ulcers for elective debridement. Ultrasound-assisted neuraxial technique was performed to administer isobaric bupivacaine into the L4\u2013L5 intrathecal space. This report highlights the efficient use of ultrasound as an alternative to traditional landmark-based technique in cases of severe scoliosis and SB. A patient-centred anaesthetic plan\u2014emphasising preoperative optimisation, haemodynamic and respiratory stability, immobility and postoperative pain control\u2014is critical for optimal perioperative outcomes in this complex population.<\/jats:p>","DOI":"10.1136\/bcr-2025-271667","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T15:10:51Z","timestamp":1777302651000},"page":"e271667","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-assisted neuraxial anaesthesia in an adult patient with repaired spina bifida, scoliosis and difficult airway"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1912-5876","authenticated-orcid":false,"given":"Arcel V","family":"Adizas","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, University of the Philippines-Philippine General Hospital Department of Anesthesiology, Manila, National Capital Region, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vidal","family":"Esguerra","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of the Philippines-Philippine General Hospital Department of Anesthesiology, Manila, National Capital Region, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joniday","family":"Nieva-Salonga","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of the Philippines-Philippine General Hospital Department of Anesthesiology, Manila, National Capital Region, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"2026042407302512000_19.4.e271667.1","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1007\/s11884-024-00755-5","article-title":"Long-Term Quality of Life for Patients with Spina Bifida","volume":"19","author":"Ball","year":"2024","journal-title":"Curr Bladder Dysfunct Rep"},{"key":"2026042407302512000_19.4.e271667.2","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1080\/09638288.2019.1621953","article-title":"50 Years and older - born with spina bifida: participation, health issues and physical function","volume":"43","author":"Lidal","year":"2021","journal-title":"Disabil Rehabil"},{"key":"2026042407302512000_19.4.e271667.3","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1007\/s00381-015-2845-9","article-title":"A practical clinical classification of spinal neural tube defects","volume":"31","author":"McComb","year":"2015","journal-title":"Childs Nerv Syst"},{"key":"2026042407302512000_19.4.e271667.4","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302902"},{"key":"2026042407302512000_19.4.e271667.5","doi-asserted-by":"publisher","DOI":"10.1159\/000056005"},{"key":"2026042407302512000_19.4.e271667.6","doi-asserted-by":"publisher","DOI":"10.1310\/sci2302-155"},{"key":"2026042407302512000_19.4.e271667.7","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e31818de070"},{"key":"2026042407302512000_19.4.e271667.8","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.bjae.2024.02.004","article-title":"Perioperative management of patients with spina bifida","volume":"24","author":"Hartigan","year":"2024","journal-title":"BJA Educ"},{"key":"2026042407302512000_19.4.e271667.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)08140-3"},{"key":"2026042407302512000_19.4.e271667.10","doi-asserted-by":"crossref","unstructured":"Ahmed S , Alali M , Atuel G , et al . 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