Anesthetic management of cesarean section in a patient with Léri-Weill dyschondrosteosis – A case report

When providing spinal anesthesia for patients with achondroplasia, a dose reduction is often recommended to prevent respiratory arrest and total spinal blocks as patients with achondroplasia present with spinal complications such as spinal cord stenosis, kyphoscoliosis, and lumbar lordosis. This case report describes why this dose reduction is unnecessary in patients with Léri–Weill dyschondrosteosis (LWD) dwarfism and how a regular spinal neuraxial approach is safe and efficacious. A 38-year-old pregnant woman with physical findings consistent with LWD and unremarkable past medical history presented for a repeat elective cesarean section. On examination, the patient was noted to have conserved spinal length and anatomy. In accordance with current recommendations, this patient received a 20% reduced spinal anesthetic dose for her cesarean section based on her height. The cesarean was uneventful. Additional dose reduction was found to be unnecessary due to normal spinal length and anatomy. This characteristic of LWD warrants a review of the clinical recommendations surrounding the anesthetic management of patients with LWD.