Ultrasound-assisted neuraxial anaesthesia in a parturient with congenital kyphoscoliosis and prior spinal instrumentation: A case report

Sunil S, Nirenjen SM, Venkatesh S

Pdf Page Numbers :- 308-310

Sunil S¹, Nirenjen SM^1,* and Venkatesh S¹

¹Department of Anesthesiology and Pain Medicine, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai - 600116, Tamil Nadu, India

*Corresponding author: Dr. Nirenjen SM, Assistant professor, Department of Anaesthesiology and Pain Medicine, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai - 600116, Tamil Nadu, India. Email: niren7708@gmail.com

Received 18 April 2025; Revised 3 June 2025; Accepted 11 June 2025; Published 19 June 2025

Citation: Sunil S, Nirenjen SM, Venkatesh S. Ultrasound-assisted neuraxial anaesthesia in a parturient with congenital kyphoscoliosis and prior spinal instrumentation: A case report. J Med Sci Res. 2025; 13(3):308-310. DOI: http://dx.doi.org/10.17727/JMSR.2025/13-54

Copyright: © 2025 Sunil S et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PDF

Abstract

Pregnant patients with kyphoscoliotic deformities, particularly those of congenital origin, present unique anaesthetic challenges due to distorted vertebral anatomy, restrictive lung disease, and compromised cardiopulmonary reserve. Previous spinal surgery may obscure surface landmarks and alter interlaminar anatomy, making neuraxial blockade technically difficult. Nevertheless, with meticulous preoperative assessment, interdisciplinary planning, and the adjunctive use of ultrasonography, neuraxial anaesthesia remains a viable option. Preoperative ultrasound facilitates identification of intervertebral spaces, estimates the depth of the epidural space, and improves first-attempt success rates. Its integration into regional anaesthesia practice enhances both the safety and success of neuraxial blocks, reaffirming its value as a standard of care in high-risk obstetric patients with complex spinal deformities. In our case we see a G2L1 patient with congenital kyphoscoliosis with previous instrumentation came for elective LSCS.

Keywords: congenital kyphoscoliosis; caesarean section; neuraxial anaesthesia; obstetric anaesthesia