TY - JOUR T1 - Pragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system JF - Regional Anesthesia & Pain Medicine JO - Reg Anesth Pain Med SP - 258 LP - 267 DO - 10.1136/rapm-2020-101792 VL - 46 IS - 3 AU - Elisa Walsh AU - Yi Zhang AU - Hannah Madden AU - James Lehrich AU - Lisa Leffert Y1 - 2021/03/01 UR - http://rapm.bmj.com/content/46/3/258.abstract N2 - Neuraxial anesthesia provides optimal labor analgesia and cesarean delivery anesthesia. Obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system present unique challenges to the anesthesiologist. Potential concerns include mechanical interference, patient injury and the need for imaging. Unfortunately, the existing literature regarding neuraxial anesthesia in these patients is largely limited to case series and rare retrospective studies. The lack of practice guidance may lead to unwarranted fear of patient harm and subsequent avoidance of neuraxial anesthesia for cesarean delivery or neuraxial analgesia for labor, with additional risks of exposure to general anesthesia. In this narrative review, we use available evidence to recommend a framework when considering neuraxial anesthesia for an obstetrical patient with neuraxial pathology. ER -