{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T03:30:00Z","timestamp":1773113400342,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2023,12,5]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p>In current clinical practice, spinal anesthesia and analgesia techniques\u2014including epidural and subarachnoid procedures\u2014are frequently executed without imaging like X-ray or epidurography. Unrecognized spinal pathology has resulted in serious morbidity in the context of performing neuraxial anesthesia. Typically, preoperative consultations incorporate a patient\u2019s medical history but lack a detailed spinal examination or consideration of recent MRI or CT scans. In contrast, within the domain of pain clinics, a multidisciplinary approach involving anesthesiologists and neuroradiologists is common. Such collaborative settings rely on exhaustive clinical history and scrutinization of recent imaging studies, which may influence the decision to proceed with invasive spinal interventions. There are no epidemiological data concerning rates of the different baseline pathologies that would potentially pose morbidity risks from neuraxial procedures, but the most common among these is canal stenosis, which significantly affects almost 20% of people over 60 years of age. This paper aims to elucidate these critical findings and advocate for incorporating meticulous preoperative assessments for individuals slated for spinal anesthesia or analgesia procedures, thereby attempting to mitigate potential risks.<\/jats:p>","DOI":"10.1136\/rapm-2023-105106","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T19:50:14Z","timestamp":1705953014000},"page":"832-839","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Neuraxial pathology and regional anesthesia: an education guide to decision-making"],"prefix":"10.1136","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0363-8037","authenticated-orcid":false,"given":"Martin","family":"Avellanal","sequence":"first","affiliation":[{"name":"Pain Clinic, Hospital Universitario La Moraleja, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Riquelme","sequence":"additional","affiliation":[{"name":"Pain Clinic, Hospital Universitario La Moraleja, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Ferreiro","sequence":"additional","affiliation":[{"name":"Universidad San Pablo CEU, Madrid, Spain"},{"name":"Radiology, Hospital Universitario de Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1221-1214","authenticated-orcid":false,"given":"Andre","family":"Boezaart","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA"},{"name":"Lumina Health, Sarrey, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9078-1020","authenticated-orcid":false,"given":"Miguel Angel","family":"Reina","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, CEU San Pablo University Faculty of Medicine, Madrid, Spain"},{"name":"University of Florida College of Medicine, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,22]]},"reference":[{"key":"2025101113082593000_49.11.832.1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep096"},{"key":"2025101113082593000_49.11.832.2","doi-asserted-by":"crossref","first-page":"4665","DOI":"10.3390\/ijms24054665","article-title":"Spinal cord injury and complications related to neuraxial anaesthesia procedures: A systematic review","volume":"24","author":"Pozza","year":"2023","journal-title":"IJMS"},{"key":"2025101113082593000_49.11.832.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2007.10.033"},{"key":"2025101113082593000_49.11.832.4","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/01.JAA.0000569788.21941.ca","article-title":"Lumbar spinal stenosis","volume":"32","author":"Andaloro","year":"2019","journal-title":"JAAPA"},{"key":"2025101113082593000_49.11.832.5","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1007\/s00586-020-06524-2","article-title":"A systematic review of developmental lumbar spinal stenosis","volume":"29","author":"Lai","year":"2020","journal-title":"Eur Spine J"},{"key":"2025101113082593000_49.11.832.6","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1097\/01.brs.0000250979.12398.96","article-title":"Degenerative lumbar Spondylolisthesis: an Epidemiological perspective: the Copenhagen osteoarthritis study","volume":"32","author":"Jacobsen","year":"2007","journal-title":"Spine (Phila Pa 1976)"},{"key":"2025101113082593000_49.11.832.7","first-page":"7","article-title":"Clinical implications of epidural fat in the spinal canal. A scanning electron microscopic study","volume":"60","author":"Reina","year":"2009","journal-title":"Acta Anaesthesiol Belg"},{"key":"2025101113082593000_49.11.832.8","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000295803.31074.dc"},{"key":"2025101113082593000_49.11.832.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2009.03.005"},{"key":"2025101113082593000_49.11.832.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-022-05485-5","article-title":"Consensus on a standardised treatment pathway algorithm for lumbar spinal stenosis: an international Delphi study","volume":"23","author":"Comer","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"2025101113082593000_49.11.832.11","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.rdc.2018.03.008","article-title":"Lumbar spinal stenosis in older adults","volume":"44","author":"Lafian","year":"2018","journal-title":"Rheum Dis Clin North Am"},{"key":"2025101113082593000_49.11.832.12","first-page":"409","article-title":"Prone position MRI of the lumbar spine in patients with low back pain and\/or Radiculopathy refractory to treatment","volume":"25","author":"Avellanal","year":"2022","journal-title":"Pain Physician"},{"key":"2025101113082593000_49.11.832.13","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/s00276-009-0493-z","article-title":"Reliability of Tuffier\u2019s line evaluated on cadaver specimens","volume":"31","author":"Windisch","year":"2009","journal-title":"Surg Radiol Anat"},{"key":"2025101113082593000_49.11.832.14","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-00115550-200809000-00005"},{"key":"2025101113082593000_49.11.832.15","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S263646"},{"key":"2025101113082593000_49.11.832.16","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000286"},{"key":"2025101113082593000_49.11.832.17","doi-asserted-by":"crossref","first-page":"827","DOI":"10.4103\/ajns.AJNS_83_21","article-title":"Symptomatic Postsurgical lumbar Pseudomeningocele treated by ultrasound-guided epidural blood patch application","volume":"16","author":"Kavishwar","year":"2021","journal-title":"Asian J Neurosurg"},{"key":"2025101113082593000_49.11.832.18","doi-asserted-by":"crossref","first-page":"e391","DOI":"10.1016\/j.wneu.2021.08.071","article-title":"Classification and reliability of lumbar facet cysts grading scales","volume":"155","author":"Page","year":"2021","journal-title":"World Neurosurg"},{"key":"2025101113082593000_49.11.832.19","doi-asserted-by":"crossref","DOI":"10.25259\/SNI_153_2022","article-title":"Review\/perspective on the diagnosis and surgical management of spinal Arachnoid cysts","volume":"13","author":"Epstein","year":"2022","journal-title":"Surg Neurol Int"},{"key":"2025101113082593000_49.11.832.20","doi-asserted-by":"crossref","first-page":"908","DOI":"10.5435\/JAAOS-D-22-01022","article-title":"Postoperative spinal Hematoma and Seroma","volume":"31","author":"Butler","year":"2023","journal-title":"J Am Acad Orthop Surg"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2023-105106","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T20:08:33Z","timestamp":1760213313000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2023-105106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,22]]},"references-count":20,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,4]]},"published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1136\/rapm-2023-105106"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2023-105106","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,22]]}}}