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Spinal anesthesia: Technique

Alexander M DeLeon, MD
Cynthia A Wong, MD
Section Editor
Robert Maniker, MD
Deputy Editor
Marianna Crowley, MD


Spinal anesthesia is a type of neuraxial anesthesia; local anesthetic (LA) is injected into cerebrospinal fluid (CSF) in the lumbar spine to anesthetize nerves that exit the spinal cord. Spinal anesthesia is most commonly used for anesthesia and/or analgesia for a variety of lower extremity, lower abdominal, pelvic, and perineal procedures.

This topic will discuss the relevant anatomy, techniques, and management of spinal anesthesia. Indications, contraindications, preoperative evaluation, physiologic effects, and complications of spinal anesthesia are discussed separately. (See "Overview of neuraxial anesthesia", section on 'Physiologic effects of neuraxial anesthesia'.)

Techniques for other types of neuraxial anesthesia, including epidural and combined spinal-epidural, are discussed separately. (See "Epidural and combined spinal-epidural anesthesia: Techniques" and "Anesthesia and anesthetic choices" and "Neuraxial analgesia for labor and delivery (including instrumented delivery)", section on 'Epidural analgesia technique' and "Neuraxial analgesia for labor and delivery (including instrumented delivery)", section on 'CSE analgesia'.)


Spinal anesthesia is performed by placing a needle between the lumbar vertebrae and through the dura to inject anesthetic medication. Anatomy of the bony spine and vertebrae are discussed in more detail separately (figure 1 and figure 2). (See "Spinal column injuries in adults: Definitions, mechanisms, and radiographs", section on 'Anatomy'.)

Anatomy related specifically to the performance of spinal anesthesia is discussed here.

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Literature review current through: Nov 2017. | This topic last updated: Sep 21, 2017.
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