{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T08:38:58Z","timestamp":1770712738777,"version":"3.49.0"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T00:00:00Z","timestamp":1626652800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,19]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Deep brain stimulation (DBS) is a U.S. Food and Drug Administration\u2013approved therapy for medically refractory Parkinson\u2019s disease, essential tremor, and other neurological conditions. The procedure requires prolonged immobility and can result in significant patient discomfort, potentially limiting patient selection. In addition, surgical requirements necessitate avoidance of medications that may alter or suppress the patient\u2019s arousal or baseline tremor during macrostimulation testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>In this study, the authors describe the use of continuous spinal anesthesia with local anesthetic to manage a patient with severe back pain who was intolerant of semisupine position during stereotactic computed tomography and stage 1 of DBS placement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Continuous spinal anesthesia is an effective strategy to manage patients with severe back pain undergoing DBS surgery for upper extremity motor symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case21285","type":"journal-article","created":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T03:03:06Z","timestamp":1626663786000},"source":"Crossref","is-referenced-by-count":0,"title":["Intrathecal catheter for severe low back pain during deep brain stimulation placement: illustrative case"],"prefix":"10.3171","volume":"2","author":[{"given":"Bryan","family":"Kunkler","sequence":"first","affiliation":[{"name":"Departments of Anesthesiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Tung","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parag G.","family":"Patil","sequence":"additional","affiliation":[{"name":"Neurological Surgery, University of Michigan Medical School, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srinivas","family":"Chiravuri","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vijay","family":"Tarnal","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1093\/bja\/aep179","article-title":"Anaesthesia for deep brain stimulation and in patients with implanted neurostimulator devices","volume":"103","author":"Poon CC","year":"2009","unstructured":"Poon CC, Irwin MG. Anaesthesia for deep brain stimulation and in patients with implanted neurostimulator devices. Br J Anaesth. 2009;103(2):152\u2013165.10.1093\/bja\/aep17926655725"},{"issue":"3","key":"b2","series-title":"Stereotact Funct Neurosurg","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1159\/000380827","article-title":"Deep brain stimulation significantly decreases disability from low back pain in patients with advanced Parkinson\u2019s disease","volume":"93","author":"Smith H","year":"2015","unstructured":"Smith H, Gee L, Kumar V,  Deep brain stimulation significantly decreases disability from low back pain in patients with advanced Parkinson\u2019s disease. Stereotact Funct Neurosurg. 2015;93(3):206\u2013211.10.1159\/00038082726655725"},{"issue":"4","key":"b3","series-title":"Nat Rev Neurol","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1038\/s41582-019-0145-9","article-title":"Long-term outcomes of deep brain stimulation in Parkinson disease","volume":"15","author":"Limousin P","year":"2019","unstructured":"Limousin P, Foltynie T. Long-term outcomes of deep brain stimulation in Parkinson disease. Nat Rev Neurol. 2019;15(4):234\u2013242.10.1038\/s41582-019-0145-9"},{"issue":"5","key":"b4","series-title":"Eur J Neurol","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1111\/j.1468-1331.2006.01298.x","article-title":"Is there a role for physiotherapy during deep brain stimulation surgery in patients with Parkinson\u2019s disease?","volume":"13","author":"Chevrier E","year":"2006","unstructured":"Chevrier E, Fraix V, Krack P,  Is there a role for physiotherapy during deep brain stimulation surgery in patients with Parkinson\u2019s disease? Eur J Neurol. 2006;13(5):496\u2013498.10.1111\/j.1468-1331.2006.01298.x"},{"key":"b5","series-title":"Front Med (Lausanne)","doi-asserted-by":"publisher","first-page":"133","DOI":"10.3389\/fmed.2017.00133","article-title":"Continuous spinal anesthesia for obstetric anesthesia and analgesia","volume":"4","author":"Veli\u010dkovi\u0107 I","year":"2017","unstructured":"Veli\u010dkovi\u0107 I, Pujic B, Baysinger CW, Baysinger CL. Continuous spinal anesthesia for obstetric anesthesia and analgesia. Front Med (Lausanne). 2017;4:133.10.3389\/fmed.2017.00133"},{"issue":"2","key":"b6","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1093\/bja\/65.2.237","article-title":"Extradural anaesthesia in patients with previous lumbar spine surgery","volume":"65","author":"Sharrock NE","year":"1990","unstructured":"Sharrock NE, Urquhart B, Mineo R. Extradural anaesthesia in patients with previous lumbar spine surgery. Br J Anaesth. 1990;65(2):237\u2013239.10.1093\/bja\/65.2.237"},{"issue":"5","key":"b7","series-title":"Anesth Analg","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1213\/01.ane.0000286169.02429.11","article-title":"Intrathecal opioids for control of chronic low back pain during deep brain stimulation procedures","volume":"105","author":"Lotto M","year":"2007","unstructured":"Lotto M, Boulis NM. Intrathecal opioids for control of chronic low back pain during deep brain stimulation procedures. Anesth Analg. 2007;105(5):1410\u20131412.10.1213\/01.ane.0000286169.02429.11"},{"issue":"3","key":"b8","series-title":"Anesthesiology","first-page":"535","article-title":"Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration: an updated report by the American Society of Anesthesiologists Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine","volume":"124","year":"2016","unstructured":"American Society of Anesthesiologists. Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration: an updated report by the American Society of Anesthesiologists Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology. 2016;124(3):535\u2013552."},{"issue":"6","key":"b9","series-title":"Neuromodulation","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1111\/ner.12766","article-title":"Comparison of awake vs. asleep surgery for subthalamic deep brain stimulation in Parkinson\u2019s disease","volume":"21","author":"Blasberg F","year":"2018","unstructured":"Blasberg F, Wojtecki L, Elben S,  Comparison of awake vs. asleep surgery for subthalamic deep brain stimulation in Parkinson\u2019s disease. Neuromodulation. 2018;21(6):541\u2013547.10.1111\/ner.12766"},{"issue":"2","key":"b1","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1093\/bja\/aep179","article-title":"Anaesthesia for deep brain stimulation and in patients with implanted neurostimulator devices","volume":"103","author":"Poon CC","year":"2009","unstructured":"Poon CC, Irwin MG. Anaesthesia for deep brain stimulation and in patients with implanted neurostimulator devices. Br J Anaesth. 2009;103(2):152\u2013165.10.1093\/bja\/aep179"},{"issue":"3","key":"b2","series-title":"Stereotact Funct Neurosurg","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1159\/000380827","article-title":"Deep brain stimulation significantly decreases disability from low back pain in patients with advanced Parkinson\u2019s disease","volume":"93","author":"Smith H","year":"2015","unstructured":"Smith H, Gee L, Kumar V,  Deep brain stimulation significantly decreases disability from low back pain in patients with advanced Parkinson\u2019s disease. Stereotact Funct Neurosurg. 2015;93(3):206\u2013211.10.1159\/000380827"},{"issue":"4","key":"b3","series-title":"Nat Rev Neurol","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1038\/s41582-019-0145-9","article-title":"Long-term outcomes of deep brain stimulation in Parkinson disease","volume":"15","author":"Limousin P","year":"2019","unstructured":"Limousin P, Foltynie T. Long-term outcomes of deep brain stimulation in Parkinson disease. Nat Rev Neurol. 2019;15(4):234\u2013242.10.1038\/s41582-019-0145-9"},{"issue":"5","key":"b4","series-title":"Eur J Neurol","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1111\/j.1468-1331.2006.01298.x","article-title":"Is there a role for physiotherapy during deep brain stimulation surgery in patients with Parkinson\u2019s disease?","volume":"13","author":"Chevrier E","year":"2006","unstructured":"Chevrier E, Fraix V, Krack P,  Is there a role for physiotherapy during deep brain stimulation surgery in patients with Parkinson\u2019s disease? Eur J Neurol. 2006;13(5):496\u2013498.10.1111\/j.1468-1331.2006.01298.x"},{"key":"b5","series-title":"Front Med (Lausanne)","doi-asserted-by":"publisher","first-page":"133","DOI":"10.3389\/fmed.2017.00133","article-title":"Continuous spinal anesthesia for obstetric anesthesia and analgesia","volume":"4","author":"Veli\u010dkovi\u0107 I","year":"2017","unstructured":"Veli\u010dkovi\u0107 I, Pujic B, Baysinger CW, Baysinger CL. Continuous spinal anesthesia for obstetric anesthesia and analgesia. Front Med (Lausanne). 2017;4:133.10.3389\/fmed.2017.00133"},{"issue":"2","key":"b6","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1093\/bja\/65.2.237","article-title":"Extradural anaesthesia in patients with previous lumbar spine surgery","volume":"65","author":"Sharrock NE","year":"1990","unstructured":"Sharrock NE, Urquhart B, Mineo R. Extradural anaesthesia in patients with previous lumbar spine surgery. Br J Anaesth. 1990;65(2):237\u2013239.10.1093\/bja\/65.2.237"},{"issue":"5","key":"b7","series-title":"Anesth Analg","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1213\/01.ane.0000286169.02429.11","article-title":"Intrathecal opioids for control of chronic low back pain during deep brain stimulation procedures","volume":"105","author":"Lotto M","year":"2007","unstructured":"Lotto M, Boulis NM. Intrathecal opioids for control of chronic low back pain during deep brain stimulation procedures. Anesth Analg. 2007;105(5):1410\u20131412.10.1213\/01.ane.0000286169.02429.11"},{"issue":"3","key":"b8","series-title":"Anesthesiology","first-page":"535","article-title":"Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration: an updated report by the American Society of Anesthesiologists Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine","volume":"124","year":"2016","unstructured":"American Society of Anesthesiologists. Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration: an updated report by the American Society of Anesthesiologists Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology. 2016;124(3):535\u2013552."},{"issue":"6","key":"b9","series-title":"Neuromodulation","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1111\/ner.12766","article-title":"Comparison of awake vs. asleep surgery for subthalamic deep brain stimulation in Parkinson\u2019s disease","volume":"21","author":"Blasberg F","year":"2018","unstructured":"Blasberg F, Wojtecki L, Elben S,  Comparison of awake vs. asleep surgery for subthalamic deep brain stimulation in Parkinson\u2019s disease. Neuromodulation. 2018;21(6):541\u2013547.10.1111\/ner.12766"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/2\/3\/article-CASE21285.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/2\/3\/article-CASE21285.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/2\/3\/article-CASE21285.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T14:53:54Z","timestamp":1770303234000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/2\/3\/article-CASE21285.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,19]]},"references-count":18,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/case21285","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,19]]}}}