Ultrasound-assisted neuraxial anaesthesia in a parturient with congenital kyphoscoliosis and prior spinal instrumentation: A case report

Pregnant patients with kyphoscoliotic deformities, particularly those of congenital origin, present unique anaesthetic challenges due to distorted vertebral anatomy, restrictive lung disease, and compromised cardiopulmonary reserve. Previous spinal surgery may obscure surface landmarks and alter interlaminar anatomy, making neuraxial blockade technically difficult. Nevertheless, with meticulous preoperative assessment, interdisciplinary planning, and the adjunctive use of ultrasonography, neuraxial anaesthesia remains a viable option. Preoperative ultrasound facilitates identification of intervertebral spaces, estimates the depth of the epidural space, and improves first-attempt success rates. Its integration into regional anaesthesia practice enhances both the safety and success of neuraxial blocks, reaffirming its value as a standard of care in high-risk obstetric patients with complex spinal deformities. In our case we see a G2L1 patient with congenital kyphoscoliosis with previous instrumentation came for elective LSCS.