Anesthesiology/lumber block

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Question
Dear Mr Starkman. Is it normal to have a spinal block just before or during a L5 discectomy.?

Could this spinal anesthesia be administrated by spinal needle at S2 level through defect hole in sacrum at level S2 before or during L5 discectomy.?
Thank you

Answer
It's not routinely done, since your surgeon would immediately post-operatively want to do a neurological exam to assure no nerves were damaged during the operation.  This would not be possible if the nerves had been blocked with a spinal anesthetic.  As the dura sac which holds the CSF terminates at about S2 this level may be too low to reliably provide a spinal anesthetic.

Anesthesiology

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JM Starkman, MD

Experience

Over twenty-five years of adult and pediatric, inpatient and outpatient clinical anesthesia practice--some private, some group.

Organizations
American Association of Physicians and Surgeons. My county medical society.

Publications
[not a researcher]

Education/Credentials
American medical school graduate. Board Certified. Fellowship trained Cardiovascular and Pediatric anesthesia subspecialist.

Past/Present Clients
Over 20,000 anesthetics, the majority of which have been personally managed, with less than 5% consisting of supervising nurse anesthetists or in-training resident physicians.

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