PT  - JOURNAL ARTICLE
AU  - Elisa Walsh
AU  - Yi Zhang
AU  - Hannah Madden
AU  - James Lehrich
AU  - Lisa Leffert
TI  - Pragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system
AID  - 10.1136/rapm-2020-101792
DP  - 2021 Mar 01
TA  - Regional Anesthesia & Pain Medicine
PG  - 258--267
VI  - 46
IP  - 3
4099  - http://rapm.bmj.com/content/46/3/258.short
4100  - http://rapm.bmj.com/content/46/3/258.full
SO  - Reg Anesth Pain Med2021 Mar 01; 46
AB  - 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.