Jiang Yongzhou, Wang Yonghui, Wang Fahan, He Tao, Li Quan, Zhang Jiao, Lu Zhihong
Department of Anesthesiology and Perioperative Medicine, Provincial Key Laboratory of Traditional Chinese Medicine, Xijing Hospital, Fourth Military Medical University, Changle West Rd. 127, Xincheng District, Xi'an, Shaanxi 710032, China.
J Surg Case Rep. 2025 Jul 15;2025(7):rjaf479. doi: 10.1093/jscr/rjaf479. eCollection 2025 Jul.
Spinal anesthesia (SA) is preferred for cesarean delivery but poses technical challenges in patients with spinal deformities or cerebrovascular disorders. This report describes the successful use of ultrasound-assisted SA in a parturient with surgically corrected scoliosis and moyamoya disease. A 28-year-old female at 37 weeks of gestation with history of surgery for scoliosis (post-thoracolumbar instrumentation) and moyamoya disease underwent elective cesarean section. Severe spinal curvature, metallic implants, and scarring obscured anatomical landmarks. Preprocedural ultrasound identified the L3-L4 interspace, enabling single-attempt SA with optimal sensory blockade (T8-T10). No complications occurred. Ultrasound guidance enhances SA success in complex cases by overcoming anatomical challenges, ensuring hemodynamic stability, and minimizing procedural risks. This technique warrants broader adoption in patients with spinal deformities and comorbid conditions.
剖宫产时首选脊髓麻醉（SA），但对于脊柱畸形或脑血管疾病患者而言，实施该麻醉存在技术挑战。本报告描述了超声辅助SA在一名接受过脊柱侧弯手术矫正且患有烟雾病的产妇中的成功应用。一名28岁、孕37周的女性，有脊柱侧弯手术史（胸腰段器械植入术后）和烟雾病，接受了择期剖宫产。严重的脊柱弯曲、金属植入物和瘢痕掩盖了解剖标志。术前超声确定了L3-L4间隙，使得单次SA操作成功并实现了最佳感觉阻滞（T8-T10）。未发生并发症。超声引导通过克服解剖学挑战、确保血流动力学稳定并将操作风险降至最低，提高了复杂病例中SA的成功率。该技术值得在脊柱畸形及合并其他病症的患者中更广泛地应用。
