Laminectomy Under Spinal Anesthesia in a Patient with Chronic Obstructive Pulmonary Disease: A Case Report

Background: Lumbar laminectomy is frequently performed to alleviate spinal cord compression caused by herniated lumbar discs. Selecting the most appropriate anesthetic technique is vital, particularly in patients with coexisting conditions, including chronic obstructive pulmonary disease (COPD). For individuals at elevated risk of pulmonary complications, spinal anesthesia (SA) may offer advantages over general anesthesia (GA). This report explored the outcomes and safety of SA in a patient diagnosed with COPD undergoing lumbar decompression surgery. Case Presentation: A 32-year-old male with a body mass index of 23 kg/m² underwent L4-L5 laminectomy due to persistent, severe radicular pain in his left leg unresponsive to conservative treatment. His medical history included significant tobacco use and a diagnosis of COPD, raising concerns about potential respiratory complications associated with GA. Consequently, SA was selected. The procedure was performed successfully with no intraoperative complications, and the patient was discharged 48 hours post-surgery with stable respiratory function. At a two-week follow-up, he reported complete resolution of pain and improvement in neurological function. Conclusion: In patients with COPD, SA during laminectomy can maintain spontaneous respiration, lower the risk of pulmonary issues, and promote faster postoperative recovery. Nevertheless, vigilant intraoperative monitoring of hemodynamics and oxygenation remains essential. While this case supports the use of SA in such scenarios, broader studies are necessary to validate these findings.