Ultrasound-assisted spinal anesthesia in a parturient with scoliosis and moyamoya disease undergoing cesarean section: a case report.

Spinal anesthesia (SA) is preferred for cesarean delivery but poses technical challenges in patients with spinal deformities or cerebrovascular disorders. This report describes the successful use of ultrasound-assisted SA in a parturient with surgically corrected scoliosis and moyamoya disease. A 28-year-old female at 37 weeks of gestation with history of surgery for scoliosis (post-thoracolumbar instrumentation) and moyamoya disease underwent elective cesarean section. Severe spinal curvature, metallic implants, and scarring obscured anatomical landmarks. Preprocedural ultrasound identified the L3-L4 interspace, enabling single-attempt SA with optimal sensory blockade (T8-T10). No complications occurred. Ultrasound guidance enhances SA success in complex cases by overcoming anatomical challenges, ensuring hemodynamic stability, and minimizing procedural risks. This technique warrants broader adoption in patients with spinal deformities and comorbid conditions.