title: Radiological Evaluation of the Line Between the Crista Iliaca (Tuffier's line) in Elderly Patients.
abstract: OBJECTIVE
  Tuffier's line is defined as the line connecting the highest points of both iliac crests, which generally passes through either the body of the fourth lumbar vertebra or the intervertebral space between fourth and fifth vertebrae. In this study, we assessed the radiological correlation of the level of Tuffier's line with changes in age and sex.
  
  
  METHODS
  In this study, antero-posterior pelvic X-rays of 590 patients aged 18 and older were retrospectively analyzed. It is revealed that Tuffier's line crosses the vertebral column at one of three levels, which are the L4 vertebral body, L4-L5 vertebral interspace and L5 vertebral body. Patients' sex, age and vertebral level of the Tuffier's line were recorded. Data was analyzed using the chi-square test.
  
  
  RESULTS
  The assessment of the X-rays of 317 female patients showed that Tuffier's Line passes through the L4 vertebral body in 115 (37.8%), through the L4-L5 intervertebral space in 126 (40%) and through the L5 vertebral body in 76 (22.2%) patients. A Tuffier's line passing through the level of the L5 vertebral body was found to be statistically significant in female patients (p=0.00). No significant relevance was found between male gender and the level of Tuffier's line in 273 male patients. It is found that the height of the vertebral levels that Tuffier's line crosses does not correlate with mean age of the groups (p=0.939).
  
  
  CONCLUSIONS
  It should be considered that Tuffier's line can cross at vertebral levels other than anticipated. The level of Tuffier's line should be precisely determined with supplementary radiological methods, such as AP pelvic X-ray in addition to physical examination, to reduce the complications in association with regional anaeshesia and to achieve sensorial block levels sufficient to sustain a comfortable surgery, particularly in female patients who carry higher cardiac and respiratory risks.
authors.affiliation: Clinic of Anaesthesiology and Reanimation, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
authors.forename: Burcu Özalp
authors.initials: BÖ
authors.lastname: Horsanalı
authors.affiliation: Clinic of Anaesthesiology and Reanimation, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
authors.forename: Zeki Tuncel
authors.initials: ZT
authors.lastname: Tekgül
authors.affiliation: Clinic of Anaesthesiology and Reanimation, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
authors.forename: Murat Yaşar
authors.initials: MY
authors.lastname: Özkalkanlı
authors.affiliation: Clinic of Radiology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
authors.forename: Zehra Hilal
authors.initials: ZH
authors.lastname: Adıbelli
authors.affiliation: Clinic of Radiology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Esen
authors.affiliation: Clinic of Anaesthesiology and Reanimation, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
authors.forename: Fulya Yılmaz
authors.initials: FY
authors.lastname: Duran
keywords: Tuffier’s line; age; crista iliac; sex