The purpose of this study was to identify the patient position for lumbar puncture associated with the widest interspinous distance utilizing ultrasound. Sixteen healthy adult volunteers were placed in three positions commonly used for lumbar puncture (lateral recumbent with knees to chest, sitting and bent forward over an adjustable bedside stand, and sitting with feet supported and chest to knees) and the distance between lumbar spinous processes was measured by ultrasound. Measurements were compared between the three positions. Differences were analyzed using Tukey's honestly significant difference test. The results showed that the interspinous distance was significantly greater in the "sitting, feet supported" position than in the other two positions ( P<0.001). The "sitting, feet supported" position may offer advantages for selected patients undergoing lumbar puncture. Ultrasonography may be a useful adjunct when performing lumbar puncture in the emergency department.
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http://dx.doi.org/10.1007/s10140-003-0286-3 | DOI Listing |
No Shinkei Geka
January 2025
Department of Neurosurgery, Takeda General Hospital.
Vertebroplasty has shown excellent analgesic effects in patients with osteoporotic vertebral fractures. In Japan, percutaneous vertebroplasty, balloon kyphoplasty, and vertebral body stenting are commonly performed. All of these techniques require precise transpedicular vertebral puncture and complete cement filling without leakage.
View Article and Find Full Text PDFJ Anesth Analg Crit Care
January 2025
Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", via Sergio Pansini 5, Naples, 80100, Italy.
Labor analgesia is increasingly widespread throughout the world with a rate ranging from 10 to 60%. The benefits regarding clinical and non-clinical maternal-fetal outcomes are currently discussed in international scientific literature. Even stage of labor needs a different and appropriate approach to control the pain; however, different techniques are reported in literature.
View Article and Find Full Text PDFCureus
December 2024
Anesthesiology, South Brooklyn Health, Brooklyn, USA.
The efficacy of epidural blood patch (EBP) is highly variable, and often, clinicians are unable to identify the underlying reasons for treatment failure. A 36-year-old parturient underwent a "blind" epidural blood patch (EBP) without image guidance but failed to obtain relief from a postural headache related to the labor epidural. During the second EBP, an intact plica mediana dorsalis (PMD) was visualized in the anterior-posterior fluoroscopic view after injection of contrast, and autologous blood was injected on both sides of the PMD, leading to the complete resolution of headache symptoms.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Institute of Neurological Sciences, Prince of Wales Hospital and the University of New South Wales, Randwick, Sydney, New South Wales, Australia
Acute cerebellar ataxia is a clinical syndrome that involves loss of balance and coordination, typically within less than 72 hours. It usually presents in children and rarely affect adults. A woman in her early 20s presented with acute onset dizziness, vertigo, truncal ataxia and dysarthria 2 weeks following an acute viral illness.
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