Could ultrasonography be used by an anaesthetist to identify a specified lumbar interspace before spinal anaesthesia?
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.
Watson
M J
MJ
Department of Anaesthetics, Glasgow Royal Infirmary, Glasgow G4 0SF, UK. mwatson@doctors.org.uk
Evans
S
S
Thorp
J M
JM
D000328:Adult; D000368:Aged; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007278:Injections, Spinal / Q000009:adverse effects / Q000379:methods; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000209:etiology / Q000517:prevention & control; D013346:Subarachnoid Space / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014463:Ultrasonography