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Spinal Anatomy (spinal + anatomy)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Real-time ultrasound-guided spinal anesthesia in patients with a challenging spinal anatomy: two case reports

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2010
K. J. CHIN
Spinal anesthesia may be challenging in patients with poorly palpable surface landmarks or abnormal spinal anatomy. Pre-procedural ultrasound imaging of the lumbar spine can help by providing additional anatomical information, thus permitting a more accurate estimation of the appropriate needle insertion site and trajectory. However, actual needle insertion in the pre-puncture ultrasound- assisted technique remains a ,blind' procedure. We describe two patients with an abnormal spinal anatomy in whom ultrasound-assisted spinal anesthesia was unsuccessful. Successful dural puncture was subsequently achieved using a technique of real-time ultrasound- guided spinal anesthesia. This may be a useful option in patients in whom landmark-guided and ultrasound-assisted techniques have failed. [source]

Three-dimensional sonographic evaluation of the infant spine: Preliminary findings

JOURNAL OF CLINICAL ULTRASOUND, Issue 1 2003
Jacqueline A. Hughes MBBS
Abstract Purpose The aims of this study were to evaluate normal spinal anatomy in neonates and infants as seen by 3-dimensional sonography (3D US), to determine the value of 3D US in the evaluation of occult spinal dysraphia in infants, and to correlate the findings of 3D US with those of 2-dimensional sonography (2D US) and MRI, when available. Methods We used 2D US and 3D US to examine the lumbosacral spine in infants with cutaneous stigmata, syndromes associated with spinal dysraphia, and abnormal radiographs. We also evaluated, as controls, healthy infants who had no markers of spinal abnormality. 2D sonograms, 3D sonograms, radiographs, and MRI scans, when available, were compared to assess differences in the display of the infant spine. Results In total, we examined 29 infants: 18 subjects and 11 control infants. The correlation between 2D US and 3D US was 100% in the detection of congenital defects of the spinal cord, although 3D US allowed superior visualization of the vertebral bodies and posterior spinal elements. When a gross abnormality of the posterior spinal elements occurred with pathologic overlying soft tissue, interpretation was simpler with MRI than with sonography. Conclusions 3D US is a useful adjunct to 2D US when screening the infant spine for congenital defects, particularly in showing alignment of posterior spinal elements and integrity of vertebral bodies. This ability is important because posterior spinal defects may be associated with underlying spinal cord abnormalities. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 31:9,20, 2003 [source]

Ultrasound control for presumed difficult epidural puncture

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2001
T. Grau
Background: The efficacy of epidural anaesthesia depends on the accurate identification of the epidural space (ES). Abnormal anatomical conditions may make the procedure difficult or impossible. The aim of this study was to investigate whether pre-puncture ultrasound examination of the spinal anatomy might be beneficial in expected cases of difficult epidural anaesthesia. Methods: We used digital ultrasound equipment with a 5-MHz transducer to assess the anatomy of the ES and the posterior parts of the spinal column. We examined 72 parturients with abnormal anatomical conditions who were scheduled for epidural anaesthesia. The women were randomised into two equal groups. In all patients, the standard loss of resistance technique was used. In the ultrasound group, an ultrasound examination of the appropriate spinal region was conducted prior to epidural puncture. ES depth seen on the ultrasound images was compared to the ES depth measured by the needle. We compared the number of puncture attempts with the standard method (control group) to the number of attempts under ultrasound guidance. Results: Ultrasonography significantly improved operating conditions for epidural anaesthesia. The maximum VAS scores and patient acceptance were significantly better. Conclusions: With ultrasound measurement of the ES depth, the quality of epidural anaesthesia was enhanced. [source]