{"id":9493,"date":"2024-12-11T10:46:54","date_gmt":"2024-12-11T10:46:54","guid":{"rendered":"https:\/\/www.kauveryhospital.com\/ima-journal\/?p=9493"},"modified":"2025-04-09T10:04:25","modified_gmt":"2025-04-09T10:04:25","slug":"spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach","status":"publish","type":"post","link":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/","title":{"rendered":"Spine surgery under loco-regional anaesthesia in lateral decubitus position for an elderly patient – a risk mitigation approach"},"content":{"rendered":"

[vc_row][vc_column][vc_column_text]<\/p>\n

An 85-year-old male patient, who had been bedridden for two months, presented with a chief complaint of back pain and bilateral lower limb radiculopathy. Diagnostic imaging revealed an osteoporotic compression fracture of the L2 vertebral body, accompanied by severe spinal stenosis at the L4-L5 level (fig.1 & 2). The patient\u2019s prolonged immobility, compounded by severe pain, had precipitated the development of a chest infection, further exacerbated by his persistent decubitus position over the preceding weeks.<\/p>\n

Clinical Evaluation and Multidisciplinary Approach<\/b><\/strong><\/h2>\n

The complex clinical presentation of the patient necessitated a multidisciplinary management strategy, involving discussions regarding the most appropriate therapeutic interventions. One potential approach considered was vertebroplasty for the L2 vertebral fracture, in combination with epidural steroid injections for the L4-L5 stenosis, both to be performed under local anesthesia. However, given the presence of motor weakness (muscle power 4\/5) in both lower limbs and the significant severity of the spinal stenosis, the potential efficacy of epidural steroids was regarded with skepticism.<\/p>\n

An alternative intervention involved vertebroplasty in conjunction with surgical decompression of the L4-L5 spinal canal under general anaesthesia. However, due to\u00a0 the patient\u2019s significant comorbidities, particularly an active lower respiratory tract infection, the use of general anaesthesia was deemed high-risk. In addition, such a decision carried the potential for necessitating postoperative ventilatory support, further complicating the clinical course. Spinal anaesthesia was considered as a safer alternative, though performing the procedure with the patient in an awake prone position posed logistical challenges, particularly with respect to patient tolerance and respiratory mechanics. Furthermore, prone position poses difficulty in intubation in case of an emergency need.<\/p>\n

After thorough consultation with the anaesthesia team, it was determined that the most viable surgical approach would be to position the patient in the left lateral decubitus position. This positioning reduced the respiratory risk profile, though it presented several technical challenges related to altered three-dimensional orientation, instrument handling, limited visibility of the surgical field, and modifications in intraoperative radiographic assessment.<\/p>\n

Surgical Procedure<\/strong><\/h2>\n

Stage 1: Vertebroplasty was performed on the L2 vertebral body using local anesthesia in standard prone position. One of the rare but serious complication of vertebroplasty is cement leakage into the spinal canal which needs immediate decompression surgery if associated with neurological deficit. Hence, spinal anaesthesia is not advisable for vertebroplasty as immediate neurological assessment is not possible. Post-procedure, neurological examination revealed no deterioration.<\/p>\n

Stage 2: The procedure was performed under spinal anaesthesia, with the patient positioned in the left lateral decubitus position. Adequate padding was applied over the patient\u2019s bony prominences to prevent pressure injuries (fig.3). Decompression of the L4-L5 spinal stenosis was performed through a posterior midline approach. Standard instruments and techniques were utilised (fig.4). The operative table was tilted to achieve a sloppy lateral position when dealing with the lateral recess stenosis. Surprisingly, the surgical field was much better than in standard prone position as gravity played a major role in clearing the field of oozing blood. Adequate decompression of dura and nerve roots achieved. Wound closed in standard fashion after thorough haemostasis.<\/p>\n

Postoperative Management and Outcome<\/strong><\/h2>\n

Postoperatively, the patient tolerated the procedure well and was gradually mobilized with appropriate assistance. His recovery was closely monitored, and he received intensive rehabilitation, including chest physiotherapy, as part of the management plan for his respiratory infection. Additionally, appropriate medical therapy was administered to address the underlying respiratory infection. The patient made gradual progress and was eventually discharged with ongoing outpatient follow-up.<\/p>\n

Conclusion<\/strong><\/h2>\n

This case highlights the complexities involved in managing elderly patients with osteoporotic vertebral fractures, spinal stenosis, and concomitant comorbidities. A tailored, multidisciplinary approach, involving careful consideration of the risks associated with anaesthesia and positioning, was crucial to the successful management of this patient. The combined use of vertebroplasty and surgical decompression, performed under loco-regional anaesthesia in a left lateral position, proved to be an effective and safe strategy for alleviating the patient\u2019s symptoms while mitigating respiratory risks.<\/p>\n

Fig.1: T2 sagittal MR image showing vertebral compression fracture of L2 and severe stenosis at L4-5 level<\/p>\n

\"\"<\/p>\n

Fig.2:\u00a0T2\u00a0sagittal\u00a0and\u00a0axial\u00a0MR\u00a0images showing\u00a0severe\u00a0stenosis of\u00a0L4-L5\u00a0level<\/p>\n

\"\"<\/p>\n

Fig.3:\u00a0Patient in lateral decubitus position, strapped onto the operating table with adequate\u00a0padding<\/p>\n

\"\"<\/p>\n

Fig.4:\u00a0Decompression\u00a0surgery\u00a0in\u00a0lateral decubitus\u00a0under\u00a0spinal\u00a0anaesthesia<\/p>\n

\"\"<\/p>\n

Fig.5: Postoperative x-ray \u2013 showing post vertebroplasty status in L2 vertebra and decompression at L4-5 level<\/p>\n

\"\"<\/p>\n

KAUVERY<\/b><\/strong>\u00a0<\/b><\/strong>SPINE<\/b><\/strong>\u00a0<\/b><\/strong>INSTITUTE<\/b><\/strong><\/h2>\n

Dr. G. Balamurali<\/strong>
\nChief Consultant and Head of Spine Surgery<\/em><\/p>\n

Dr. S. Somasundar<\/strong>
\nConsultant Orthopaedic Spine Surgeon<\/em><\/p>\n

Dr. Mohamed Najibullah<\/strong>
\nConsultant Anaesthetist[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column width=”1\/2″][vc_column_text]Author :<\/strong><\/p>\n

\"DrDr. Mirunaalini Thangavelan<\/strong>
\nDNB postgraduate in Orthopaedics Surgery<\/em>
\nKauvery Hospital, Chennai<\/p>\n

 <\/p>\n

[\/vc_column_text][\/vc_column][vc_column width=”1\/2″][vc_column_text]Mentor<\/strong><\/p>\n

\"Dr.Keerthivasan\"Dr. P. Keerthivasan<\/strong>
\nConsultant Orthopaedic Spine Surgeon<\/em>
\nKauvery Hospital, Chennai[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"

[vc_row][vc_column][vc_column_text] An 85-year-old male patient, who had been bedridden for two months, presented with a chief complaint of back pain and bilateral lower limb radiculopathy. Diagnostic imaging revealed an osteoporotic<\/p>\n","protected":false},"author":2,"featured_media":9502,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[82],"tags":[],"class_list":["post-9493","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ima-journal-december-2024"],"yoast_head":"\nSpine surgery under loco-regional anaesthesia in lateral decubitus position for an elderly patient - a risk mitigation approach<\/title>\n<meta name=\"description\" content=\"An 85-year-old male patient, who had been bedridden for two months, presented with a chief complaint of back pain and bilateral lower limb radiculopathy.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Spine surgery under loco-regional anaesthesia in lateral decubitus position for an elderly patient - a risk mitigation approach\" \/>\n<meta property=\"og:description\" content=\"An 85-year-old male patient, who had been bedridden for two months, presented with a chief complaint of back pain and bilateral lower limb radiculopathy.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/\" \/>\n<meta property=\"og:site_name\" content=\"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health\" \/>\n<meta property=\"article:published_time\" content=\"2024-12-11T10:46:54+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-04-09T10:04:25+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2024\/12\/background-banner-dec-24-6.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1308\" \/>\n\t<meta property=\"og:image:height\" content=\"545\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"kh-ima-admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"kh-ima-admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/\",\"url\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/\",\"name\":\"Spine surgery under loco-regional anaesthesia in lateral decubitus position for an elderly patient - a risk mitigation approach\",\"isPartOf\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2024\/12\/background-banner-dec-24-6.jpg\",\"datePublished\":\"2024-12-11T10:46:54+00:00\",\"dateModified\":\"2025-04-09T10:04:25+00:00\",\"author\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/a008aa764057e74557d708f2381a5acb\"},\"description\":\"An 85-year-old male patient, who had been bedridden for two months, presented with a chief complaint of back pain and bilateral lower limb radiculopathy.\",\"breadcrumb\":{\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/#primaryimage\",\"url\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2024\/12\/background-banner-dec-24-6.jpg\",\"contentUrl\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2024\/12\/background-banner-dec-24-6.jpg\",\"width\":1308,\"height\":545},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Spine surgery under loco-regional anaesthesia in lateral decubitus position for an elderly patient – a risk mitigation approach\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#website\",\"url\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/\",\"name\":\"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health\",\"description\":\"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/a008aa764057e74557d708f2381a5acb\",\"name\":\"kh-ima-admin\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/6b190d48867033f0c3c0aac5530295535596218654f543741508cab11520ab8f?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/6b190d48867033f0c3c0aac5530295535596218654f543741508cab11520ab8f?s=96&d=mm&r=g\",\"caption\":\"kh-ima-admin\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Spine surgery under loco-regional anaesthesia in lateral decubitus position for an elderly patient - a risk mitigation approach","description":"An 85-year-old male patient, who had been bedridden for two months, presented with a chief complaint of back pain and bilateral lower limb radiculopathy.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/","og_locale":"en_US","og_type":"article","og_title":"Spine surgery under loco-regional anaesthesia in lateral decubitus position for an elderly patient - a risk mitigation approach","og_description":"An 85-year-old male patient, who had been bedridden for two months, presented with a chief complaint of back pain and bilateral lower limb radiculopathy.","og_url":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/","og_site_name":"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health","article_published_time":"2024-12-11T10:46:54+00:00","article_modified_time":"2025-04-09T10:04:25+00:00","og_image":[{"width":1308,"height":545,"url":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2024\/12\/background-banner-dec-24-6.jpg","type":"image\/jpeg"}],"author":"kh-ima-admin","twitter_card":"summary_large_image","twitter_misc":{"Written by":"kh-ima-admin","Est. reading time":"5 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/","url":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/","name":"Spine surgery under loco-regional anaesthesia in lateral decubitus position for an elderly patient - a risk mitigation approach","isPartOf":{"@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/#primaryimage"},"image":{"@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/#primaryimage"},"thumbnailUrl":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2024\/12\/background-banner-dec-24-6.jpg","datePublished":"2024-12-11T10:46:54+00:00","dateModified":"2025-04-09T10:04:25+00:00","author":{"@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/a008aa764057e74557d708f2381a5acb"},"description":"An 85-year-old male patient, who had been bedridden for two months, presented with a chief complaint of back pain and bilateral lower limb radiculopathy.","breadcrumb":{"@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/#primaryimage","url":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2024\/12\/background-banner-dec-24-6.jpg","contentUrl":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-content\/uploads\/2024\/12\/background-banner-dec-24-6.jpg","width":1308,"height":545},{"@type":"BreadcrumbList","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-december-2024\/spine-surgery-under-loco-regional-anaesthesia-in-lateral-decubitus-position-for-an-elderly-patient-a-risk-mitigation-approach\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.kauveryhospital.com\/ima-journal\/"},{"@type":"ListItem","position":2,"name":"Spine surgery under loco-regional anaesthesia in lateral decubitus position for an elderly patient – a risk mitigation approach"}]},{"@type":"WebSite","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/#website","url":"https:\/\/www.kauveryhospital.com\/ima-journal\/","name":"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health","description":"Kauvery Hospital | Patient Newsletters | A Monthly Newsletter from your Partners in Good Health","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.kauveryhospital.com\/ima-journal\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/a008aa764057e74557d708f2381a5acb","name":"kh-ima-admin","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.kauveryhospital.com\/ima-journal\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/6b190d48867033f0c3c0aac5530295535596218654f543741508cab11520ab8f?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/6b190d48867033f0c3c0aac5530295535596218654f543741508cab11520ab8f?s=96&d=mm&r=g","caption":"kh-ima-admin"}}]}},"_links":{"self":[{"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/posts\/9493","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/comments?post=9493"}],"version-history":[{"count":11,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/posts\/9493\/revisions"}],"predecessor-version":[{"id":9551,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/posts\/9493\/revisions\/9551"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/media\/9502"}],"wp:attachment":[{"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/media?parent=9493"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/categories?post=9493"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.kauveryhospital.com\/ima-journal\/wp-json\/wp\/v2\/tags?post=9493"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}