Skip to main content


Log in

Intraoperative total spinal anesthesia as a complication of posterior percutaneous endoscopic cervical discectomy

  • Case Report
  • Published:
European Spine Journal Aims and scope Submit manuscript



Percutaneous endoscopic cervical discectomy (PECD) is an emerging surgical treatment for cervical disc herniation in recent years, but the complications of PECD are rarely reported. In this case report, we aimed to report two cases of total spinal anesthesia, an unusual complication of PECD.

Methods and Results

One patient became unconscious with unstable vital signs and another patient appeared with numbness of both arms and legs during PECD operation.


From these two cases, we concluded that the operation of anchoring during PECD should be cautious and standardized, intravenous anesthesia should be chosen to enhance intraoperative anesthesia to prevent intraoperative total spinal anesthesia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2


  1. Yang JS, Chu L, Chen L et al (2014) Anterior or posterior approach of full-endoscopic cervical discectomy for cervical intervertebral disc herniation? A comparative cohort study. Spine (Phila Pa 1976) 39(21):1743–1750.

    Article  Google Scholar 

  2. Burkhardt BW, Müller S, Oertel JM (2016) Influence of prior cervical surgery on surgical outcome of endoscopic posterior cervical foraminotomy for osseous foraminal stenosis. World Neurosurg 95:14–21.

    Article  PubMed  Google Scholar 

  3. Ruetten S, Komp M, Merk H, Godolias G (2008) Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine (Phila Pa 1976) 33(9):940–948.

    Article  Google Scholar 

  4. Ruetten S, Komp M, Merk H et al (2007) A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes: prospective 2-year results of 87 patients. Minim Invasive Neurosurg 50(4):219–226.

    Article  PubMed  CAS  Google Scholar 

  5. Oertel JM, Philipps M, Burkhardt BW (2016) Endoscopic posterior cervical foraminotomy as a treatment for osseous foraminal stenosis. World Neurosurg 91:50–57.

    Article  PubMed  Google Scholar 

  6. Ruetten S, Komp M, Merk H, Godolias G (2009) Full-endoscopic anterior decompression versus conventional anterior decompression and fusion in cervical disc herniations. Int Orthop 33(6):1677–1682.

    Article  PubMed  Google Scholar 

  7. Ahn Y, Lee SH, Chung SE et al (2005) Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation. Neuroradiology 47:924–930.

    Article  PubMed  CAS  Google Scholar 

  8. Tzaan WC (2011) Anterior percutaneous endoscopic cervical discectomy for cervical intervertebral disc herniation: outcome, complications, and technique. J Spinal Disord Tech 24(7):421–431.

    Article  PubMed  Google Scholar 

  9. Deng ZL, Chu L, Chen L et al (2016) Anterior transcorporeal approach of percutaneous endoscopic cervical discectomy for disc herniation at the C4–C5 levels: a technical note. Spine J 16(5):659–666.

    Article  PubMed  Google Scholar 

  10. Yao N, Wang C, Wang W et al (2011) Full-endoscopic technique for anterior cervical discectomy and interbody fusion: 5-year follow-up results of 67 cases. Eur Spine J 20(6):899–904.

    Article  PubMed  Google Scholar 

  11. Ting HY, Tsui BC (2014) Reversal of high spinal anesthesia with cerebrospinal lavage after inadvertent intrathecal injection of local anesthetic in an obstetric patient. Can J Anaesth 61(11):1004–1007.

    Article  PubMed  Google Scholar 

  12. Siddik-Sayyid SM, Gellad PH, Aouad MT (2012) Total spinal block after spinal anesthesia following ongoing epidural analgesia for cesarean delivery. J Anesth 26(2):312–313.

    Article  PubMed  Google Scholar 

  13. Musaid RA, Naranjo TM (2006) Spinal block complications in obstetrics and gynecology patients. Neurosciences (Riyadh) 11(3):140–144

    Google Scholar 

  14. Steffek M, Owczuk R, Szlyk-Augustyn M et al (2004) Total spinal anaesthesia as a complication of local anaesthetic test-dose administration through an epidural catheter. Acta Anaesthesiol Scand 48(9):1211–1213.

    Article  PubMed  CAS  Google Scholar 

  15. Hartung HJ, Luiz T (1992) Total spinal anesthesia. A complication of lumbar catheter peridural anesthesia for postoperative analgesia. Anaesthesist 41(5):285–287

    PubMed  CAS  Google Scholar 

  16. Boezaart AP, Thorburn JR (1987) Accidental total spinal block—a complication of epidural anaesthesia. A case report. S Afr Med J 71(9):596

    PubMed  CAS  Google Scholar 

  17. Woerth SD, Bullard JR, Alpert CC (1977) Total spinal anesthesia, a late complication of epidural anesthesia. Anesthesiology 47(4):380–381

    Article  PubMed  CAS  Google Scholar 

  18. Albi-Feldzer A, Duceau B, Nguessom W et al (2016) A severe complication after ultrasound-guided thoracic paravertebral block for breast cancer surgery: total spinal anaesthesia: A case report. Eur J Anaesthesiol 33(12):949–951.

    Article  PubMed  Google Scholar 

  19. Beyaz SG, Özocak H, Ergönenç T et al (2014) Total Spinal Block after Thoracic Paravertebral Block. Turk J Anaesthesiol Reanim 42(1):43–45.

    Article  PubMed  Google Scholar 

  20. Dogan Z, Bakan M, Idin K et al (2014) Total spinal block after lumbar plexus block: a case report. Braz J Anesthesiol 64(2):121–123.

    Article  PubMed  Google Scholar 

  21. Chaudhri BB, Macfie A, Kirk AJ (2009) Inadvertent total spinal anesthesia after intercostal nerve block placement during lung resection. Ann Thorac Surg 88(1):283–284.

    Article  PubMed  Google Scholar 

  22. Friesen D, Robinson RH (1987) Total spinal anesthesia—a complication of intercostal nerve block. Kans Med 88(3):84–96

    PubMed  CAS  Google Scholar 

  23. Otto CW, Wall CL (1976) Total spinal anesthesia: a rare complication of intrathoracic intercostal nerve block. Ann Thorac Surg 22(3):289–292

    Article  PubMed  CAS  Google Scholar 

  24. Bernards CM, Kopacz DJ, Michel MZ (1994) Effect of needle puncture on morphine and lidocaine flux through the spinal meninges of the monkey in vitro. Implications for combined spinal-epidural anesthesia. Anesthesiology. 80(4):853–858

    Article  PubMed  CAS  Google Scholar 

  25. Matsumoto M, Namiki A, Nagai H et al (1993) Pharmacokinetics of lidocaine used for total spinal anesthesia—a comparison between cervical and lumbar injection. Masui 42(6):815–818

    PubMed  CAS  Google Scholar 

Download references


Funding was provided by Chongqing Municipal Public Health Bureau, Chongqing People’s Municipal Government (CN), Award number: 2017ZDXM031.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Zhengjian Yan.

Ethics declarations

Conflict of interest

None of the authors has any potential conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wu, W., Yan, Z. Intraoperative total spinal anesthesia as a complication of posterior percutaneous endoscopic cervical discectomy. Eur Spine J 27 (Suppl 3), 431–435 (2018).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: