The Case of a Patient with Spina Bifida Occulta Who Was Given Spinal Anesthesia

Abstract

Spina bifida is a malformation of the spinal cord and its surrounding structures that leads to difficulties with spinal anesthesia. A case of a patient with spina bifida occulta who was given spinal anesthesia is presented. A woman in her 20s was to undergo a planned cesarean section due to a previous cesarean section. Preoperative magnetic resonance imaging（MRI）showed a dichotomy in the spinal cord, low-placed conus medullaris, and normal structure at the L4/5 level. Considering the patient’s wishes and the impact on the fetus, spinal anesthesia was selected as the first choice. In the operating room, the L4/5 space was confirmed by sonography, and spinal anesthesia was performed by the paramedian approach with a sufficient anesthesia area. The surgery was completed without any trouble. Spinal anesthesia for patients with spina bifida is controversial. In the present case, spinal anesthesia was performed safely with careful confirmation of the puncture position by preoperative imaging.