{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:47:01Z","timestamp":1790369221591,"version":"4.1.0"},"reference-count":140,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2020,8,22]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Neuraxial anesthesia provides optimal labor analgesia and cesarean delivery anesthesia. Obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system present unique challenges to the anesthesiologist. Potential concerns include mechanical interference, patient injury and the need for imaging. Unfortunately, the existing literature regarding neuraxial anesthesia in these patients is largely limited to case series and rare retrospective studies. The lack of practice guidance may lead to unwarranted fear of patient harm and subsequent avoidance of neuraxial anesthesia for cesarean delivery or neuraxial analgesia for labor, with additional risks of exposure to general anesthesia. In this narrative review, we use available evidence to recommend a framework when considering neuraxial anesthesia for an obstetrical patient with neuraxial pathology.<\/jats:p>","DOI":"10.1136\/rapm-2020-101792","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T17:06:21Z","timestamp":1603904781000},"page":"258-267","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Pragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system"],"prefix":"10.1136","volume":"46","author":[{"given":"Elisa","family":"Walsh","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Madden","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Lehrich","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-3811","authenticated-orcid":false,"given":"Lisa","family":"Leffert","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,28]]},"reference":[{"key":"2025090414473665000_46.3.258.1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181bc3584"},{"key":"2025090414473665000_46.3.258.2","doi-asserted-by":"crossref","first-page":"no","DOI":"10.1111\/j.1399-6576.2011.02443.x","article-title":"Neuraxial techniques in patients with pre-existing back impairment or prior spine interventions: a topical review with special reference to obstetrics","volume":"55","author":"Vercauteren","year":"2011","journal-title":"Acta Anaesthesiol Scand"},{"key":"2025090414473665000_46.3.258.3","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.ijoa.2015.04.002","article-title":"Spinal dysraphisms in the parturient: implications for perioperative anaesthetic care and labour analgesia","volume":"24","author":"Murphy","year":"2015","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.4","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/77.2.153"},{"key":"2025090414473665000_46.3.258.5","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2000.01547-4.x"},{"key":"2025090414473665000_46.3.258.6","doi-asserted-by":"publisher","DOI":"10.1053\/rapm.2000.19633"},{"key":"2025090414473665000_46.3.258.7","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000184"},{"key":"2025090414473665000_46.3.258.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0952-8180(01)00245-8"},{"key":"2025090414473665000_46.3.258.9","first-page":"25","article-title":"Real-time ultrasonic observation of combined spinal-epidural anaesthesia","volume":"21","author":"Grau","year":"2004","journal-title":"Eur J Anaesthesiol"},{"key":"2025090414473665000_46.3.258.10","first-page":"256","article-title":"Spinal cord compression following labor and delivery with epidural analgesia","volume":"14","author":"Simon","year":"1989","journal-title":"Reg Anesth"},{"key":"2025090414473665000_46.3.258.11","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1111\/j.1479-828X.2008.00836.x","article-title":"Cauda equina syndrome post-caesarean section","volume":"48","author":"Chow","year":"2008","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"2025090414473665000_46.3.258.12","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1213\/00000539-197801000-00028","article-title":"Epidural anesthesia for cesarean section in kyphoscoliosis","volume":"57","author":"Carlson","year":"1978","journal-title":"Anesth Analg"},{"key":"2025090414473665000_46.3.258.13","doi-asserted-by":"crossref","first-page":"445???447","DOI":"10.1213\/00000539-199004000-00017","article-title":"Continuous spinal anesthesia with combined hyperbaric and isobaric bupivacaine in a patient with scoliosis","volume":"70","author":"Moran","year":"1990","journal-title":"Anesth Analg"},{"key":"2025090414473665000_46.3.258.14","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1007\/BF03011811","article-title":"Anaesthetic management of a parturient with severe muscular dystrophy, lumbar lordosis and a difficult airway","volume":"43","author":"Pash","year":"1996","journal-title":"Can J Anaesth"},{"key":"2025090414473665000_46.3.258.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1991.tb09714.x"},{"key":"2025090414473665000_46.3.258.16","doi-asserted-by":"crossref","first-page":"379","DOI":"10.3126\/kumj.v6i3.1716","article-title":"Anaesthetic management of a parturient with severe kyphoscoliosis","volume":"6","author":"Bansal","year":"2008","journal-title":"Kathmandu Univ Med J"},{"key":"2025090414473665000_46.3.258.17","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jclinane.2006.08.013","article-title":"Neuraxial anesthesia for cesarean delivery in a parturient with type 1 von Willebrand disease and scoliosis","volume":"19","author":"Butwick","year":"2007","journal-title":"J Clin Anesth"},{"key":"2025090414473665000_46.3.258.18","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1007\/s12630-008-9029-y","article-title":"Spinal anesthesia for cesarean delivery in a parturient with spondylocostal dysostosis","volume":"56","author":"Dolak","year":"2009","journal-title":"Can J Anaesth"},{"key":"2025090414473665000_46.3.258.19","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181e6389a"},{"key":"2025090414473665000_46.3.258.20","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.ijoa.2017.11.004","article-title":"Anesthetic management of mosaic Turner\"s syndrome posted for elective cesarean delivery after spontaneous pregnancy","volume":"34","author":"Kalopita","year":"2018","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.21","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.ijoa.2013.06.005","article-title":"Elective cesarean delivery in a parturient with Klippel-Feil syndrome","volume":"22","author":"Kavanagh","year":"2013","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.22","doi-asserted-by":"crossref","first-page":"130","DOI":"10.2174\/157488611795684668","article-title":"Safety of spinal anesthesia in a patient with achondroplasia for cesarean section","volume":"6","author":"Mikhael","year":"2011","journal-title":"Curr Drug Saf"},{"key":"2025090414473665000_46.3.258.23","doi-asserted-by":"crossref","first-page":"377","DOI":"10.4103\/0970-9185.83686","article-title":"Epidural anesthesia for repeat cesarean delivery in a parturient with Klippel-Feil syndrome","volume":"27","author":"Smith","year":"2011","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"2025090414473665000_46.3.258.24","doi-asserted-by":"crossref","DOI":"10.3171\/2017.7.FOCUS17321","article-title":"The impact of curve severity on obstetric complications and regional anesthesia utilization in pregnant patients with adolescent idiopathic scoliosis: a preliminary analysis","volume":"43","author":"Chan","year":"2017","journal-title":"Neurosurg Focus"},{"key":"2025090414473665000_46.3.258.25","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1007\/BF03016559","article-title":"Case series: ultrasonography may assist epidural insertion in scoliosis patients","volume":"52","author":"McLeod","year":"2005","journal-title":"Can J Anaesth"},{"key":"2025090414473665000_46.3.258.26","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/83.4.670"},{"key":"2025090414473665000_46.3.258.27","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet161"},{"key":"2025090414473665000_46.3.258.28","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1007\/BF03021434","article-title":"Cesarean delivery under ultrasound-guided spinal anesthesia [corrected] in a parturient with poliomyelitis and Harrington instrumentation","volume":"55","author":"Costello","year":"2008","journal-title":"Can J Anaesth"},{"key":"2025090414473665000_46.3.258.29","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1213\/XAA.0000000000000907","article-title":"Dual epidural catheter therapy for abdominal surgery pain: 2 case reports","volume":"12","author":"Li","year":"2019","journal-title":"A&A practice"},{"key":"2025090414473665000_46.3.258.30","doi-asserted-by":"publisher","DOI":"10.1007\/BF03005423"},{"key":"2025090414473665000_46.3.258.31","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181f71234"},{"key":"2025090414473665000_46.3.258.32","first-page":"280","article-title":"Epidural anesthesia for obstetrics after spinal surgery","volume":"15","author":"Daley","year":"1990","journal-title":"Reg Anesth"},{"key":"2025090414473665000_46.3.258.33","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e3181d2462e"},{"key":"2025090414473665000_46.3.258.34","first-page":"S112","article-title":"Continuous epidural anaesthesia for obstetrics after major spinal surgery","volume":"37","author":"Daley","year":"1990","journal-title":"Can J Anaesth"},{"key":"2025090414473665000_46.3.258.35","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1007\/BF03009704","article-title":"Spinal anaesthesia for caesarean section after Harrington instrumentation","volume":"40","author":"Kardash","year":"1993","journal-title":"Can J Anaesth"},{"key":"2025090414473665000_46.3.258.36","doi-asserted-by":"crossref","first-page":"479","DOI":"10.4103\/sja.SJA_112_17","article-title":"Ultrasound-guided continuous spinal anesthesia for cesarean section in a parturient with scoliosis corrected with Harrington\"s rod surgery","volume":"11","author":"Majeed","year":"2017","journal-title":"Saudi J Anaesth"},{"key":"2025090414473665000_46.3.258.37","article-title":"Combined spinal-epidural anesthesia in parturient with Harrington rods","volume":"19","author":"Silva","year":"1994","journal-title":"Reg Anesth"},{"key":"2025090414473665000_46.3.258.38","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s00540-006-0405-x","article-title":"Spinal anesthesia using a continuous spinal catheter for cesarean section in a parturient with prior surgical correction of scoliosis","volume":"20","author":"Okutomi","year":"2006","journal-title":"J Anesth"},{"key":"2025090414473665000_46.3.258.39","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0959-289X(02)00136-X","article-title":"Regional blockade for delivery in women with scoliosis or previous spinal surgery","volume":"12","author":"Smith","year":"2003","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.40","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1213\/ANE.0000000000000690","article-title":"Labor analgesia consumption and time to neuraxial catheter placement in women with a history of surgical correction for scoliosis: a case-matched study","volume":"121","author":"Bauchat","year":"2015","journal-title":"Anesth Analg"},{"key":"2025090414473665000_46.3.258.41","doi-asserted-by":"publisher","DOI":"10.1007\/s002340000325"},{"key":"2025090414473665000_46.3.258.42","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1111\/j.1365-2044.2005.04411.x","article-title":"Spina bifida, tethered cord and regional anaesthesia","volume":"60","author":"Ali","year":"2005","journal-title":"Anaesthesia"},{"key":"2025090414473665000_46.3.258.43","unstructured":"NINDS . Spina bifida fact sheet. NIH Publication, 2013: 13\u2013309."},{"key":"2025090414473665000_46.3.258.44","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1097\/BRS.0b013e3181a98560","article-title":"Prevalence of sacral spina bifida occulta and its relationship to age, sex, race, and the sacral table angle: an anatomic, osteologic study of three thousand one hundred specimens","volume":"34","author":"Eubanks","year":"2009","journal-title":"Spine"},{"key":"2025090414473665000_46.3.258.45","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1007\/BF03009634","article-title":"The obstetrical anaesthesia assessment clinic: a review of six years experience","volume":"40","author":"Rosaeg","year":"1993","journal-title":"Can J Anaesth"},{"key":"2025090414473665000_46.3.258.46","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-289X(98)90007-3"},{"key":"2025090414473665000_46.3.258.47","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1111\/j.1365-2044.1988.tb05602.x","article-title":"Spina bifida occulta and epidural anaesthesia","volume":"43","author":"McGrady","year":"1988","journal-title":"Anaesthesia"},{"key":"2025090414473665000_46.3.258.48","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1981.tb10205.x"},{"key":"2025090414473665000_46.3.258.49","doi-asserted-by":"publisher","DOI":"10.3171\/2010.5.FOCUS1090"},{"key":"2025090414473665000_46.3.258.50","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2005.11.002"},{"key":"2025090414473665000_46.3.258.51","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1213\/XAA.0000000000000966","article-title":"Spinal cord trauma during subarachnoid anesthesia for cesarean delivery: a case report","volume":"12","author":"Palmer","year":"2019","journal-title":"A A Pract"},{"key":"2025090414473665000_46.3.258.52","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1111\/j.1399-6576.2007.01348.x","article-title":"Labor analgesia for the parturient with spina bifida","volume":"51","author":"Kuczkowski","year":"2007","journal-title":"Acta Anaesthesiol Scand"},{"key":"2025090414473665000_46.3.258.53","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s00404-006-0147-x","article-title":"Labor analgesia for pregnant women with spina bifida: what does an obstetrician need to know?","volume":"275","author":"Kuczkowski","year":"2007","journal-title":"Arch Gynecol Obstet"},{"key":"2025090414473665000_46.3.258.54","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.ijoa.2012.08.007","article-title":"Management of a parturient with an anterior sacral meningocele","volume":"22","author":"McGregor","year":"2013","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.55","first-page":"293","article-title":"Prevalence and percutaneous drainage of cysts of the sacral nerve root sheath (Tarlov cysts)","volume":"15","author":"Paulsen","year":"1994","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025090414473665000_46.3.258.56","doi-asserted-by":"crossref","DOI":"10.3171\/foc.2003.15.2.15","article-title":"Diagnosis and management of sacral Tarlov cysts. Case report and review of the literature","volume":"15","author":"Acosta","year":"2003","journal-title":"Neurosurg Focus"},{"key":"2025090414473665000_46.3.258.57","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep096"},{"key":"2025090414473665000_46.3.258.58","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2006.12.005"},{"key":"2025090414473665000_46.3.258.59","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ijoa.2017.10.004","article-title":"Successful spinal anaesthesia in a patient with a Tarlov cyst","volume":"34","author":"Pfund","year":"2018","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.60","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1046\/j.1525-1403.1999.00041.x","article-title":"Spinal cord stimulation, conception, pregnancy, and labor: case study in a complex regional pain syndrome patient","volume":"2","author":"Segal","year":"1999","journal-title":"Neuromodulation"},{"key":"2025090414473665000_46.3.258.61","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1111\/j.1525-1403.2009.00240.x","article-title":"Spinal cord stimulation in the first two trimesters of pregnancy: case report and review of the literature","volume":"12","author":"Saxena","year":"2009","journal-title":"Neuromodulation"},{"key":"2025090414473665000_46.3.258.62","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.ijoa.2009.08.006","article-title":"Caesarean section in a parturient with a spinal cord stimulator","volume":"19","author":"Sommerfield","year":"2010","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.63","first-page":"131","article-title":"Urgent cesarean section in a patient with a spinal cord stimulator: implications for surgery and anesthesia","volume":"14","author":"Patel","year":"2014","journal-title":"Ochsner J"},{"key":"2025090414473665000_46.3.258.64","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1326-9"},{"key":"2025090414473665000_46.3.258.65","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/ner.12217","article-title":"Lack of body positional effects on paresthesias when stimulating the dorsal root ganglion (DRG) in the treatment of chronic pain","volume":"18","author":"Kramer","year":"2015","journal-title":"Neuromodulation"},{"key":"2025090414473665000_46.3.258.66","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/ner.12228","article-title":"One-year outcomes of spinal cord stimulation of the dorsal root ganglion in the treatment of chronic neuropathic pain","volume":"18","author":"Liem","year":"2015","journal-title":"Neuromodulation"},{"key":"2025090414473665000_46.3.258.67","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/tog.12083","article-title":"Pregnancy and spinal cord injury","volume":"16","author":"Dawood","year":"2014","journal-title":"Obstet Gynecol"},{"key":"2025090414473665000_46.3.258.68","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.1998.00337.x"},{"key":"2025090414473665000_46.3.258.69","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/BF03008714","article-title":"Obstetrical anaesthesia and analgesia in chronic spinal cord-injured women","volume":"39","author":"Crosby","year":"1992","journal-title":"Can J Anaesth"},{"key":"2025090414473665000_46.3.258.70","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2003.12.003"},{"key":"2025090414473665000_46.3.258.71","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1213\/00000539-199907000-00025","article-title":"Treatment of autonomic hyperreflexia in a quadriplegic patient by epidural anesthesia in the postoperative period","volume":"89","author":"Murphy","year":"1999","journal-title":"Anesth Analg"},{"key":"2025090414473665000_46.3.258.72","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1097\/AOG.0000000000003843","article-title":"Obstetric management of patients with spinal cord injuries: ACOG Committee opinion summary, number 808","volume":"135","year":"2020","journal-title":"Obstet Gynecol"},{"key":"2025090414473665000_46.3.258.73","first-page":"415","article-title":"Autonomic hyperreflexia in a pregnant paraplegic patient. Case report","volume":"19","author":"Owen","year":"1994","journal-title":"Reg Anesth"},{"key":"2025090414473665000_46.3.258.74","first-page":"1176","article-title":"[Labor management using epidural anesthesia in a gravida patient with high spinal injury]","volume":"55","author":"Yamada","year":"2006","journal-title":"Masui"},{"key":"2025090414473665000_46.3.258.75","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1159\/000292562","article-title":"Epidural morphine bupivacaine combination for the control of autonomic hyperreflexia during labor","volume":"37","author":"Pauzner","year":"1994","journal-title":"Gynecol Obstet Invest"},{"key":"2025090414473665000_46.3.258.76","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.ijoa.2004.05.006","article-title":"Anaesthetic management of labour in a woman with quadriplegia and autonomic hyperreflexia","volume":"13","author":"Jadhav","year":"2004","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.77","first-page":"462","article-title":"[Combined spinal and epidural anesthesia for cesarean delivery in a patient with a cervical fracture at C2]","volume":"62","author":"Mochidome","year":"2013","journal-title":"Masui"},{"key":"2025090414473665000_46.3.258.78","first-page":"161","article-title":"Autonomic dysreflexia in a parturient with spinal cord injury","volume":"57","author":"Osgood","year":"2006","journal-title":"Acta Anaesthesiol Belg"},{"key":"2025090414473665000_46.3.258.79","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1097\/00003643-200005000-00010","article-title":"Combined spinal-epidural anaesthesia for caesarean section in a paraplegic woman: difficulty in obtaining the expected level of block","volume":"17","author":"Agostoni","year":"2000","journal-title":"Eur J Anaesthesiol"},{"key":"2025090414473665000_46.3.258.80","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002530"},{"key":"2025090414473665000_46.3.258.81","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000763"},{"key":"2025090414473665000_46.3.258.82","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1111\/j.1365-2044.1985.tb10889.x","article-title":"Cardiovascular effects of spinal subarachnoid anaesthesia. A study in patients with chronic spinal cord injuries","volume":"40","author":"Barker","year":"1985","journal-title":"Anaesthesia"},{"key":"2025090414473665000_46.3.258.83","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08220-X"},{"key":"2025090414473665000_46.3.258.84","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200009283431307"},{"key":"2025090414473665000_46.3.258.85","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199807303390501"},{"key":"2025090414473665000_46.3.258.86","first-page":"533","article-title":"The effect of injuries and illness on the course of multiple sclerosis","volume":"28","author":"Keschner","year":"1950","journal-title":"Res Publ Assoc Res Nerv Ment Dis"},{"key":"2025090414473665000_46.3.258.87","first-page":"626","article-title":"[Sequelae of spinal anesthesia]","volume":"68","author":"Stenuit","year":"1968","journal-title":"Acta Neurol Psychiatr Belg"},{"key":"2025090414473665000_46.3.258.88","doi-asserted-by":"publisher","DOI":"10.1016\/0952-8180(88)90006-2"},{"key":"2025090414473665000_46.3.258.89","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/j.annfar.2003.08.005","article-title":"[Obstetrical analgesia and anaesthesia in multiple sclerosis]","volume":"22","author":"Dalmas","year":"2003","journal-title":"Ann Fr Anesth Reanim"},{"key":"2025090414473665000_46.3.258.90","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1177\/1352458518763080","article-title":"Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS","volume":"25","author":"Lavie","year":"2019","journal-title":"Mult Scler"},{"key":"2025090414473665000_46.3.258.91","first-page":"474","article-title":"[Spinal anesthesia for cesarean section in a patient with multiple sclerosis]","volume":"62","author":"Oouchi","year":"2013","journal-title":"Masui"},{"key":"2025090414473665000_46.3.258.92","first-page":"458","article-title":"A 12-month follow-up for neurological complication after subarachnoid anesthesia in a parturient affected by multiple sclerosis","volume":"15","author":"Martucci","year":"2011","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2025090414473665000_46.3.258.93","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-013-7035-7"},{"key":"2025090414473665000_46.3.258.94","first-page":"1083","article-title":"Epidural anesthesia for cesarean section in a patient with von Hippel-Lindau disease and multiple sclerosis","volume":"88","author":"Wang","year":"1999","journal-title":"Anesth Analg"},{"key":"2025090414473665000_46.3.258.95","doi-asserted-by":"crossref","first-page":"1022???1023","DOI":"10.1213\/00000539-198212000-00014","article-title":"Lumbar epidural anesthesia in a patient with multiple sclerosis","volume":"61","author":"Warren","year":"1982","journal-title":"Anesth Analg"},{"key":"2025090414473665000_46.3.258.96","unstructured":"Salvador M , Redin J , de Carlos J . Multiple sclerosis and obstetric epidural analgesia, 1997: 33\u20135."},{"key":"2025090414473665000_46.3.258.97","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-12-165"},{"key":"2025090414473665000_46.3.258.98","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1111\/j.1365-2044.1990.tb14387.x","article-title":"Intrathecal diamorphine during laparotomy in a patient with advanced multiple sclerosis","volume":"45","author":"Leigh","year":"1990","journal-title":"Anaesthesia"},{"key":"2025090414473665000_46.3.258.99","doi-asserted-by":"crossref","first-page":"367","DOI":"10.4097\/kjae.2009.57.3.367","article-title":"Combined spinal-epidural anesthesia for caesarian section in a patients with multiple sclerosis: a case report","volume":"57","author":"Lee","year":"2009","journal-title":"Korean J Anesthesiol"},{"key":"2025090414473665000_46.3.258.100","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh152"},{"key":"2025090414473665000_46.3.258.101","first-page":"404","article-title":"[Neuraxial anesthesia in patients with multiple sclerosis - a systematic review]","volume":"67","author":"Bornemann-Cimenti","year":"2017","journal-title":"Rev Bras Anestesiol"},{"key":"2025090414473665000_46.3.258.102","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000286"},{"key":"2025090414473665000_46.3.258.103","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/j.lpm.2013.11.028","article-title":"[Anaesthetic management of patient with neurological disease: Focus on regional anaesthesia]","volume":"43","author":"Malinovsky","year":"2014","journal-title":"Presse Med"},{"key":"2025090414473665000_46.3.258.104","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/87.6.932"},{"key":"2025090414473665000_46.3.258.105","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-004-0829-7"},{"key":"2025090414473665000_46.3.258.106","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-014-1629-5"},{"key":"2025090414473665000_46.3.258.107","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1007\/BF03015490","article-title":"Epidural analgesia for labour in a parturient with neurofibromatosis","volume":"42","author":"Dounas","year":"1995","journal-title":"Can J Anaesth"},{"key":"2025090414473665000_46.3.258.108","first-page":"92","article-title":"Usefulness of intrapartum magnetic resonance imaging for a parturient with neurofibromatosis type 1 during induction of labor for preeclampsia","volume":"31","author":"Galvan","year":"2018","journal-title":"Proc"},{"key":"2025090414473665000_46.3.258.109","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.ijoa.2005.04.012","article-title":"Epidural anesthesia in a parturient with neurofibromatosis type 2 undergoing cesarean section","volume":"14","author":"Spiegel","year":"2005","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.110","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.006087"},{"key":"2025090414473665000_46.3.258.111","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/81.6.976"},{"key":"2025090414473665000_46.3.258.112","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/6096483","article-title":"Ruptured spinal arteriovenous malformation: a rare cause of paraplegia in pregnancy","volume":"2018","author":"Thiele","year":"2018","journal-title":"Case Rep Obstet Gynecol"},{"key":"2025090414473665000_46.3.258.113","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198702000-00025"},{"key":"2025090414473665000_46.3.258.114","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/j.1365-2044.1989.tb09101.x","article-title":"Spinal arteriovenous fistula. A possible cause of paraparesis after epidural anaesthesia","volume":"44","author":"Sghirlanzoni","year":"1989","journal-title":"Anaesthesia"},{"key":"2025090414473665000_46.3.258.115","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1111\/j.1399-6576.1994.tb03988.x","article-title":"Neurologic symptoms after epidural anaesthesia. Report of three cases","volume":"38","author":"Gemma","year":"1994","journal-title":"Acta Anaesthesiol Scand"},{"key":"2025090414473665000_46.3.258.116","doi-asserted-by":"crossref","first-page":"937???940","DOI":"10.1213\/00000539-198509000-00015","article-title":"Paraplegia caused by spinal angioma--possible association with epidural analgesia","volume":"64","author":"Hirsch","year":"1985","journal-title":"Anesth Analg"},{"key":"2025090414473665000_46.3.258.117","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000246274.96202.c7"},{"key":"2025090414473665000_46.3.258.118","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.ijoa.2008.12.001","article-title":"Anaesthetic management of parturients with hereditary haemorrhagic telangiectasia for caesarean section","volume":"18","author":"El Shobary","year":"2009","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.119","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.ijoa.2017.11.002","article-title":"Hereditary haemorrhagic telangiectasia in pregnancy: regional and general anaesthesia","volume":"33","author":"Crawford","year":"2018","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.120","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.2009.069013"},{"key":"2025090414473665000_46.3.258.121","doi-asserted-by":"crossref","first-page":"96???99","DOI":"10.1213\/00000539-199007000-00018","article-title":"Anesthetic management of a parturient with Osler-Weber-Rendu syndrome and rheumatic heart disease","volume":"71","author":"Waring","year":"1990","journal-title":"Anesth Analg"},{"key":"2025090414473665000_46.3.258.122","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1053\/j.semperi.2014.07.004","article-title":"Neurologic disease with pregnancy and considerations for the obstetric anesthesiologist","volume":"38","author":"Hopkins","year":"2014","journal-title":"Semin Perinatol"},{"key":"2025090414473665000_46.3.258.123","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.ijoa.2018.06.001","article-title":"Combined spinal-epidural anesthesia with non-invasive ventilation during cesarean delivery of a woman with a recent diagnosis of amyotrophic lateral sclerosis","volume":"36","author":"Kock-Cordeiro","year":"2018","journal-title":"Int J Obstet Anesth"},{"key":"2025090414473665000_46.3.258.124","first-page":"542","article-title":"Amyotrophic lateral sclerosis presenting during pregnancy","volume":"86","author":"Jacka","year":"1998","journal-title":"Anesth Analg"},{"key":"2025090414473665000_46.3.258.125","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00339-1"},{"key":"2025090414473665000_46.3.258.126","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2005.02.008"},{"key":"2025090414473665000_46.3.258.127","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.jclinane.2006.09.008","article-title":"Anesthetic management of Guillain-Barre syndrome in pregnancy","volume":"19","author":"Kocabas","year":"2007","journal-title":"J Clin Anesth"},{"key":"2025090414473665000_46.3.258.128","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2000.01367.x"},{"key":"2025090414473665000_46.3.258.129","doi-asserted-by":"publisher","DOI":"10.1053\/rapm.2001.21090"},{"key":"2025090414473665000_46.3.258.130","doi-asserted-by":"publisher","DOI":"10.1007\/BF01711227"},{"key":"2025090414473665000_46.3.258.131","first-page":"25s","article-title":"Management of Landry-Guillain-Barr\u00e9 syndrome in pregnancy","volume":"65","author":"Nelson","year":"1985","journal-title":"Obstet Gynecol"},{"key":"2025090414473665000_46.3.258.132","doi-asserted-by":"crossref","DOI":"10.1111\/j.1365-2044.1987.tb04130.x","article-title":"Management of labour and delivery in a patient with Guillain-Barr\u00e9 syndrome","volume":"42","author":"McGrady","year":"1987","journal-title":"Anaesthesia"},{"key":"2025090414473665000_46.3.258.133","doi-asserted-by":"crossref","first-page":"391","DOI":"10.4103\/0019-5049.158782","article-title":"Hyperacute onset of Guillain Barre syndrome in the immediate postpartum period following caesarean section under spinal anaesthesia","volume":"59","author":"Vinay","year":"2015","journal-title":"Indian J Anaesth"},{"key":"2025090414473665000_46.3.258.134","article-title":"Worsening of neurologic symptoms after epidural anesthesia for labor in a Guillain-Barr\u00e9 patient","volume":"98","author":"Wiertlewski","year":"2004","journal-title":"Anesth Analg"},{"key":"2025090414473665000_46.3.258.135","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000179"},{"key":"2025090414473665000_46.3.258.136","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/ACC.0b013e318291d378","article-title":"Rapid onset of guillain-barr\u00e9 syndrome after an obstetric epidural block","volume":"1","author":"Mangar","year":"2013","journal-title":"A A Case Rep"},{"key":"2025090414473665000_46.3.258.137","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1602678"},{"key":"2025090414473665000_46.3.258.138","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e32833e263f"},{"key":"2025090414473665000_46.3.258.139","unstructured":"Jaleel JA , MC R , Sadasivan M , et al . Spinal anaesthesia for LSCS in a patient with myasthenia gravis: a case report. BMH Med J."},{"key":"2025090414473665000_46.3.258.140","doi-asserted-by":"crossref","first-page":"662","DOI":"10.4097\/kjae.2009.57.5.662","article-title":"Spinal anesthesia during cesarean section in a patient with severe osteogenesis imperfecta - A case report -","volume":"57","author":"Hwang","year":"2009","journal-title":"Korean J Anesthesiol"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2020-101792","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T21:53:48Z","timestamp":1757022828000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2020-101792"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,28]]},"references-count":140,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,2,18]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/rapm-2020-101792"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2020-101792","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,28]]}}}