UAB Department of Neurosurgery PGY-6 Resident James Mooney, M.D., is first author on a recent paper published in the North American Spine Society Journal (NASSJ) titled "Microendoscopic lumbar discectomy with general versus local anesthesia: A systematic review and meta-analysis."
The authors explain that while general anesthesia is the most commonly used anesthetic method during lumbar microendoscopic discectomy, local anesthesia has been gaining popularity as an alternate method. The theoretical advantages of local anesthesia include reduced anesthesia morbidity and improved surgeon-patient communication facilitating less nerve root manipulation and yielding improved surgical outcomes.
The study showed that patients undergoing microendoscopic lumbar discectomy with general and local anesthesia both demonstrate significant improvements in quality of life. However, patients undergoing general anesthesia experience more significant improvements in back and leg pain at final follow-up when compared to local anesthesia. This study also showed that the surgeons are able to tailor the surgery to the needs and desires of the patient to provide more personalized care.
"The findings of this systematic review have implications for choice of anesthetic technique in patients undergoing lumbar microendoscopic discectomy, with general anesthesia possibly resulting in more durable pain relief outcomes. However, the studies included in this systematic review are of lower quality and further prospective and randomized investigation is needed to assess the true effects of general and local anesthesia on perioperative, surgical and patient-reported outcomes." says Mooney.
Additional authors in this study include UAB Department of Neurosurgery Assistant Professor Jakub Godzik, M.D., M.S., Nicholas Erickson, M.D. (PGY-6), Adeel Ilyas, M.D. (PGY-6), Nicholas Laskay, M.D. (PGY-5), and Anil Mahavadi, M.D. (PGY-3).
Microendoscopic lumbar discectomy with general anesthesia associated with greater improvement in leg & back pain, no difference in complications, re-operations vs local anesthesia https://t.co/HzERsrjp1j @anil_mahavadi @NitinAgarwalMD @NeurosurgeryUab @NASSspine #orthotwitter pic.twitter.com/F0UhydELEC
— NASSJ (@NASSJournal) July 11, 2022