Local vs. general anesthesia for decompression for thoracic spinal stenosis

This research was aimed to assess the safety and efficacy of local and general anesthesia for decompression for thoracic spinal stenosis (TSS). From June 2005 to December 2015, 130 cases receiving decompression for TSS were chosen for a retrospective study. The efficacy and safety of the decompression operation under two anesthetic techniques were assessed by neurological function (JOA score), postoperative efficacy (Mann's standard) and incidence of complications. The incidence of complications (spinal cord injury), operation time, intraoperative blood loss, number of days in hospital and hospitalization costs were significantly lower in the local anesthesia group; the average JOA score at 2 weeks after operation was 7 92 +/- 109 in the local anesthesia group. The paired t-test showed that all indicators were significantly better in the local anesthesia group as compared with the general anesthesia group (P<0.05); For the local anesthesia group, there were 22 cases (33.8%) achieving excellent treatment effects, 32 cases (49.2%) good effects, 10 cases (15.4%) moderate effects, and 1 case (15.4%) poor effects. The excellent and good rate was much higher in the local anesthesia group than in the general anesthesia group (P<0.05); Multivariate conditional logistic regression indicated that general anesthesia was the independent risk factor of the operation effect (OR=l.611, P=0.015). Decompression for TSS under local anesthesia has a higher safety, lower incidence of complications and lower cost. Local anesthesia can greatly reduce neurological deterioration after surgery. This approach is ideal and noteworthy for elderly patients with poor tolerance of general anesthesia.