A CASE OF L5–S1 DISC PROLAPSE UNDERGOING BILATERAL ENDOSCOPIC DISCECTOMY WITH CONTINUOUS SPINAL ANAESTHESIA

Abstract

Background: Continuous spinal anaesthesia (CSA) allows titrated intrathecal administration of local anaesthetic via an indwelling catheter, offering precise control over block height and duration. Although well suited to prolonged minimally invasive spine surgery, it remains underutilised owing to concerns over technical complexity and catheter-related complications. Case Presentation: A 43-year-old male with L5–S1 disc prolapse underwent uniportal bilateral endoscopic discectomy under CSA. Anaesthesia was instituted via a catheter placed at the L2–L3 interspace, with an initial bolus of hyperbaric bupivacaine and fentanyl achieving a T8 sensory level, followed by hourly incremental top-ups. The procedure, lasting approximately three hours, was completed with stable haemodynamics, adequate analgesia, and no neurological or catheter-related complications. Conclusion: This case illustrates that CSA, with careful incremental titration, provides a safe, stable, and flexible anaesthetic option for prolonged minimally invasive lumbar spine surgery, avoiding the risks of general anaesthesia and the rigidity of single-shot spinal techniques.