The reproducibility of the iliac crest as a marker of lumbar spine level.
The postero-anterior lumbar spine X rays of 163 patients undergoing investigation for back pain were reviewed and the spinal level marking the intersection of a line joining the iliac crests was determined. This point coincided with the L4 spinous process or the L4-5 interspace in 78.6% of patients but was as high as the L3-4 interspace in 3.7% of cases. Reliance on this landmark might lead to more cranial placement of epidural or spinal needles than was intended and this may increase the risk of spinal cord damage.
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Southampton Genral Hospital.
D000767:Anesthesia, Epidural; D001416:Back Pain / Q000000981:diagnostic imaging; D006801:Humans; D007085:Ilium / Q000033:anatomy & histology*; D008159:Lumbar Vertebrae / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D011859:Radiography