Background: Palpation has been shown to be inaccurate at identifying lumbar interspinous spaces. Our goal in this study was to compare ultrasound imaging of the region to palpation.
Methods: Using ultrasound in the postpartum period, we estimated the interspinous level used for obstetric neuraxial anesthesia in 121 women and compared this estimation with the level estimated by palpation and documented in the chart by the anesthesiologist.
Results: In 67 of 121 (55%) patients, the vertebral level of the puncture mark documented by the treating anesthesiologist was in agreement with vertebral level as assessed using ultrasound, and in 39 (32%) women, the skin puncture level was estimated by ultrasound to be at least one interspace higher. The unweighted kappa was 0.08 (95% confidence interval: 0.02, 0.14).
Conclusions: There was poor agreement between palpation and ultrasound estimation of the specific lumbar interspace, and when there was disagreement, the ultrasound estimate was more often higher than the palpitation estimate.
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http://dx.doi.org/10.1213/ane.0b013e31816069d9 | DOI Listing |
3D Print Med
January 2025
Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, 845 Sherbrooke St. W (163), Montréal, QC, H3A 0C3, Canada.
Background: There exists a need for validated lumbar spine models in spine biomechanics research. Although cadaveric testing is the current gold standard for spinal implant development, it poses significant issues related to reliability and repeatability due to the wide variability in cadaveric physiologies. Moreover, there are increasing ethical concerns with human dissection practices.
View Article and Find Full Text PDFPain Pract
February 2025
Department of Anesthesia & Critical Care, University of Chicago, Chicago, Illinois, USA.
Purpose: To determine whether preoperative magnetic resonance imaging (MRI) can reliably determine intraoperative measurements in the Vertiflex Interspinous Spacer (ISS) procedure.
Methods: Patients who underwent Vertiflex ISS with Lumbar Spinal Stenosis (LSS) and a preoperative MRI available in picture archiving and communication system (PACS) between January 2013 to February 2023 were identified retrospectively from the University of Chicago Medical Center Database. An experienced board-certified pain specialist and well-trained 2nd-year medical student independently performed measurements of the interspinous space where Vertiflex ISSs of various sizes are inserted.
Brain Spine
December 2024
Medical University of Greifswald, Department of Orthopaedics, Greifswald, Germany.
Introduction: Interspinous devices are an alternative to instrumented fusion for the treatment of lumbar spinal stenosis (LSS) with radiological instability or deformity. The devices claim to improve clinical symptoms by indirect foraminal decompression with fewer complications and similar functional outcomes compared to conventional fusion techniques, and by avoiding a (further) deterioration of the anatomy of the spine while being less invasive than instrumented fusion.
Research Question: Do interspinous devices provide a benefit in combination with a decompression of degenerative LSS?
Material And Methods: In this observational study, 117 patients were treated by decompression surgery alone (n = 37), decompression plus instrumented spinal screw fixation and anterior cage support (n = 41) or decompression plus stabilisation with interspinous devices (n = 39).
BMC Pregnancy Childbirth
December 2024
Department of Anesthesiology, West China Second University Hospital, Sichuan University, 20#, Section 3 Renmin Nan Road, Chengdu, Sichuan, 610041, PR China.
Background: While the line joining the posterior superior iliac spine (PSIS) intersects a relatively stable sacral vertebra, it does not directly facilitate the localization of lumbar interspace or assist in the positioning for neuraxial anesthesia. Our study aimed to explore the potential of the PSIS line as a reference point and to determine its practical applicability in clinical settings.
Methods: We consecutively enrolled pregnant women with gestational ages ranging from 24 to 38 weeks scheduled for magnetic resonance imaging (MRI) examination.
Magn Reson Imaging
December 2024
Neurology Unit, Department of Neurology and Human Movement Sciences, University Hospital of Siena, Siena, Italy; Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy. Electronic address:
Diffusion tensor imaging (DTI) and its parameters such as fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD) are increasingly being used to assess peripheral nerve integrity alongside nerve conduction studies. This pilot study aims to compare DTI values of lumbar spinal nerve roots before (T0) and after (T1) treatment with an interspinous process device (IPD). Seven patients (5 females, 2 males; mean age: 68) suffering from neurogenic claudication and lumbar spinal canal and foraminal stenosis were evaluated.
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