<br />Introduction<br /><br />Spinal anesthesia is a well-established regional technique commonly used for surgeries involving the lower abdomen, pelvis, and lower limbs. However, its role in lumbar spine surgeries such as laminectomy or discectomy remains an area of discussion, as general anesthesia is more frequently employed.<br /><br />Spinal Anesthesia in Back Surgery: <br /><br />Several studies have shown that spinal anesthesia can be safely used in selected patients undergoing single-level lumbar spine surgery. Its benefits include:<br />Reduced intraoperative blood loss due to lower venous pressure.<br />Blunted stress and hormonal response to surgery.<br />Faster postoperative recovery and reduced early postoperative pain.<br /><br />However, spinal anesthesia may not be suitable for longer or more complex spine surgeries where airway control and prolonged immobility are critical.<br /><br />Patient Positioning:<br /><br />Most lumbar spine surgeries are performed in the prone position to provide optimal access to the surgical field. <br /><br />When spinal anesthesia is chosen:<br />The block is usually performed in the sitting or lateral position.<br />Once adequate anesthesia is achieved, the patient is carefully turned to the prone position.<br />Challenges include:<br />1. Risk of hypotension after spinal anesthesia, which may worsen upon turning the patient prone.<br />2. Limited ability to secure or manage the airway in emergencies compared to general anesthesia.<br />3. The need for patient cooperation, as discomfort in the prone position may occur during longer procedures.<br /><br />Conclusion:<br /><br />Spinal anesthesia can be a safe and effective alternative for selected patients undergoing short, single-level lumbar spine surgeries. Nevertheless, general anesthesia remains the preferred technique for most spine surgeries due to better airway control and patient stability in the prone position.<br /><br /><br />Osamah Aziz Obaid<br /><br />Al-Mustaqbal University <br />The First University in Iraq.