Weight-based determination of spinal canal depth for paediatric lumbar punctures

Arch Dis Child. 2013 Nov;98(11):877-80. doi: 10.1136/archdischild-2013-303793. Epub 2013 Aug 21.

Abstract

Objectives: The aim of this study was to evaluate whether spinal canal depth (SCD), measured using ultrasound, could be estimated from simple body measurements in a sample of children.

Methods: We measured SCD in a group of 225 children aged 0-18 years in the curved left lateral position using ultrasound. Statistical analysis was performed using Pearson's correlation coefficient at the 5% level of significance. We also performed linear regression analyses (analysis of variance) for mid-spinal canal depth (MSCD), including five potential predictors of age, gender, height, weight and body surface area, in each model.

Results: The mean MSCD was 33.0 mm (18.1-56.4) across the whole cohort. The best linear correlation of MSCD (mm) was found with weight (W; kg), approximating the formula MSCD=0.4W+20 (R(2)=0.72). Body weight accounted for 85% of the variance in the data (adjusted R(2)=0.72). Our formula gives values outside of the actual measured SCD range in 23/225 (10.2%) of cases and estimates MSCD at 24 mm at 10 kg, 32 mm at 30 kg and 40 mm at 50 kg.

Conclusions: We demonstrate a good correlation between weight and MSCD in a large group of children. Use of the simple formula MSCD (mm)=0.4 W+20 could improve the success rates of lumbar puncture in the paediatric population, but remains to be validated.

Keywords: General Paediatrics; Imaging; Measurement.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Aging / pathology
  • Anthropometry / methods
  • Body Height / physiology
  • Body Surface Area
  • Body Weight / physiology*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lumbar Vertebrae / anatomy & histology
  • Lumbar Vertebrae / diagnostic imaging
  • Male
  • Spinal Canal / anatomy & histology*
  • Spinal Canal / diagnostic imaging
  • Spinal Puncture / methods*
  • Ultrasonography