Thoracic Segmental Spinal Anesthesia in Kyphoplasty: A Case Series

Abstract Kyphoplasty is a minimally invasive surgical procedure of the spine used to treat osteoporotic vertebral fractures that commonly affect the elderly, postmenopausal women, and patients with osteoporotic bone disease. Prolonged immobility in these patients often results in multiple comorbidities. Anesthetic modalities that have been used in kyphoplasty include general anesthesia, monitored anesthesia care, lumbar spinal anesthesia, and interfacial plane blocks, each with its advantages and disadvantages. This study examines thoracic segmental spinal anesthesia (TSSA) as an innovative anesthetic modality in treating kyphoplasty. This study investigates the case of four patients undergoing L1 kyphoplasty to evaluate its safety and efficacy. TSSA was performed at the T11–T12 interspace, and 1.5 mL of 0.5% heavy bupivacaine with 60 μg of buprenorphine was injected. The patients were positioned in a prone position after achieving the desired block level. Blood pressure, pulse, oxygen saturation, and respiratory rate were monitored throughout the procedure. Postoperative pain was assessed using the visual analog scale. Any adverse events were documented. Assessment of the results demonstrated significant perioperative benefits, including stable hemodynamics, enhanced analgesia, and early motor recovery. None of the patients complained of pain or discomfort during the procedure, and there were no instances of hypotension, bradycardia, or respiratory depression. Thus, TSSA was found to be a safe and viable anesthetic option for kyphoplasty. Our preliminary findings indicate that TSSA combined with minimal sedation can improve patient outcomes and enhance perioperative pain management. More research is needed to validate its broader application in spinal surgery.