Ultrasound-Guided Spine Anesthesia: Feasibility Study of a Guidance System.
Spinal needle injections are guided by fluoroscopy or palpation, resulting in radiation exposure and/or multiple needle re-insertions. Consequently, guiding these procedures with live ultrasound has become more popular, but images are still challenging to interpret. We introduce a guidance system based on augmentation of ultrasound images with a patient-specific 3-D surface model of the lumbar spine. We assessed the feasibility of the system in a study on 12 patients. The system could accurately provide augmentations of the epidural space and the facet joint for all subjects. Following conventional, fluoroscopy-guided needle placement, augmentation accuracy was determined according to the electromagnetically tracked final position of the needle. In 9 of 12 cases, the accuracy was considered sufficient for successfully delivering anesthesia. The unsuccessful cases can be attributed to errors in the electromagnetic tracking reference, which can be avoided by a setup reducing the influence of the metal C-arm.
Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada.
Alexander
A
Seitel
Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada.
Samira
S
Sojoudi
Department of Anesthesia, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Jill
J
Osborn
Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada.
Abtin
A
Rasoulian
Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada.
Saman
S
Nouranian
Ultrasound Department, BC Women's Hospital, Vancouver, British Columbia, Canada.
Victoria A
VA
Lessoway
Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada; Department of Mechanical Engineering, University of British Columbia, Vancouver, British Columbia, Canada.
Robert N
RN
Rohling
Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: purang@ece.ubc.ca.
Purang
P
Abolmaesumi
D000368:Aged; D000767:Anesthesia, Epidural / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D015203:Reproducibility of Results; D018084:Ultrasonography, Interventional / Q000379:methods*
Epidural needle insertions; Facet joint injections; Guidance; Model-based registration; Ultrasound