Could ultrasonography be used by an anaesthetist to identify a specified lumbar interspace before spinal anaesthesia?

Br J Anaesth. 2003 Apr;90(4):509-11. doi: 10.1093/bja/aeg096.

Abstract

Background: Insertion of a needle into the lumbar subarachnoid space may cause damage to the spinal cord. Current techniques to identify a safe interspace have limitations. Ultrasound was investigated as a means to improve anatomical accuracy.

Methods: Seventeen patients attending for elective magnetic resonance imaging (MRI) of the spine were studied. Ultrasonic identification of the L3-4 interspace was attempted by an anaesthetist and a marker was placed. A radiologist identified the anatomical location of the marker on the MRI scan.

Results: Thirteen out of 17 markers were at the L3-4 interspace; four were at the L2-3 interspace.

Conclusions: These results suggest that ultrasonography may be a useful adjunct to safe subarachnoid anaesthesia.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Anesthesia, Spinal / adverse effects
  • Anesthesia, Spinal / methods*
  • Female
  • Humans
  • Injections, Spinal / adverse effects
  • Injections, Spinal / methods
  • Lumbar Vertebrae / anatomy & histology
  • Lumbar Vertebrae / diagnostic imaging*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Spinal Cord Injuries / etiology
  • Spinal Cord Injuries / prevention & control
  • Subarachnoid Space / anatomy & histology
  • Subarachnoid Space / diagnostic imaging
  • Ultrasonography