Ultrasound-guided spinal anaesthesia for a patient with severe scoliosis.

Ultrasound (US) guided spinal anaesthesia is gaining recognition for its ability to minimise technical difficulties encountered in patients with atypical spinal anatomy. Spinal anaesthesia is administered during a surgical procedure lithotripsy in patients with respiratory complications that can result from severe scoliosis or cerebral palsy. Here, we report a case in which US-guided spinal anaesthesia proved feasible and advantageous in a patient with cerebral paralysis and severe scoliosis. A man in his 60s with cerebral paralysis and severe scoliosis was scheduled for spinal anaesthesia because of his nocturnal SpO2 drops and need for nasal high flow. Using US guidance, we confirmed that the needle entry angle was consistent with the rotating spinous process. The spinal needle was then advanced successfully, and spinal anaesthesia was administered without issue. The US technique for detecting the rotation of the vertebrae and puncturing them is useful in patients with severe scoliosis.