Noha Abdelghani¹, Tarek Youssif²*, Asmaa Ibrahem³, Daniel Thangaraj⁴, Enji Elsawy⁵, Ahmed Zaki⁶, Amir Egila⁷, Tamer Zedan⁸, Salah Ibrahim Ahmed⁹, Hesham Eissa¹⁰, Arafa Ibrahim¹¹ and Mohamed Fouad Elsayed Khalil¹²

¹Department of Anaesthesia, NMC Royal Hospital MBZ, Abu Dhabi, UAE
²Department of Neurology , Seha Clinics Abu DHABI, UAE
³Department of Neurology, Amina Hospital, Ajman , UAE
⁴Department of Anaesthesia, NMC Royal Hospital MBZ, Abu Dhabi, UAE
⁵Department of Medicine, Neurology Subspeciality, Fujairah Hospital, Emirates Health Services, UAE
⁶Department of Neurology, Ain Shams University, Cairo , Egypt
⁷Department of Neurology, NMC Specialty Hospital Al Nahda, Dubai, UAE
⁸Department of Neurology, Al Zahra Private Hospital , Dubai , UAE
⁹Department of Neurology, Sheikh Khalifa Medical City (SKMC), Abu Dhabi ,UAE
¹⁰Department of Neurology, Sheikh Sultan Bin Zayed Hospital, Batayeh, Sharjah , UAE
¹¹Department of General medicine , Madinat Zayed hospital -ADH , SEHA Abu Dhabi
¹²Department of Neurology, NMC Royal Hospital MBZ, Abu Dhabi, UAE

*Corresponding Author: Tarek Youssif, Department of Neurology , Seha Clinics Abu DHABI, UAE.

Received: September 03, 2025; Published: September 26, 2025

Abstract

Introduction: Low back pain (LBP) is a common but under-recognized complication following spinal anaesthesia.

Aim of Study: We sought to determine the prevalence of new or worsened LBP among patients who underwent various surgeries under spinal anaesthesia and identify independent procedural and patient-related predictors.

Methods: We performed a retrospective cohort study of 165 patients who had various surgeries under spinal anaesthesia from different hospitals in Middle East region. Patient demographics, anaesthetic details (needle gauge, approach, puncture position, number of attempts), surgical data (procedure type, duration, patient positioning) and history of pre-existing LBP were extracted from medical records. Univariate and multivariate logistic regression analysis (IBM SPSS v20) showed odds ratios (OR) and 95% confidence intervals (CI), with p < 0.05 considered significant.

Results: Of 165 patients, 89 (54%) developed new or worsened LBP. On univariate analysis, large-bore needles (18-22 G) (OR 15.3; 95% CI 7.1-32.8; p < 0.001), median (midline) approach (OR 9.1; 95% CI 4.3-19.0; p < 0.001), ≥ 2 puncture attempts (OR 20.6; 95% CI 9.2-46.1; p < 0.001), lateral surgical positioning (OR 13.6; 95% CI 6.4-28.9; p < 0.001) and operative duration > 60 minutes (OR 12.3; 95% CI 5.8-26.0; p < 0.001) were significantly correlated with LBP. In multivariate modelling, only ≥ 2 puncture attempts (adjusted OR 4.1; 95% CI 1.1-15.2; p = 0.038) and longer surgery (> 60 minutes) (adjusted OR 4.1; 95% CI 1.3-12.8; p = 0.014) remained independent predictors. Hosmer-Lemeshow goodness-of-fit was satisfactory (χ^2 = 5.58, p = 0.47).

Conclusion: More than half of patients experienced low back pain after spinal anaesthesia. Repeated dural puncture attempts and prolonged operative time independently increased risk. Strategies to achieve first-pass success-such as ultrasound guidance, optimized patient positioning, and experienced operators—and to minimize surgical duration may mitigate postoperative LBP.

Keywords: Spinal Anaesthesia; Low Back Pain; Puncture Attempts; Operative Duration; Median And Paramedian Approaches; Needle Gauge

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Citation

Citation: Tarek Youssif., et al. “Post-Spinal Anaesthesia Low Back Pain Prevalence and Predictors; A Multi-Centers Study from Middle East".Acta Scientific Neurology 8.10 (2025): 80-85.

Copyright

Copyright: © 2025 Tarek Youssif., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.