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Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study

BACKGROUND: Spondylolisthesis is a common degenerative spinal deformity. At the level of spondylolisthesis, the anatomy of the interlaminar space may differ from normal spine, in which case optimal angle of the needle insertion for spinal anesthesia may change. This study compared the optimal angle...

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Autores principales: Kim, Youngwon, Yoo, Seokha, Park, Sun-Kyung, Bae, Hansu, Lim, Young-Jin, Kim, Jin-Tae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424909/
https://www.ncbi.nlm.nih.gov/pubmed/34496754
http://dx.doi.org/10.1186/s12871-021-01444-0
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author Kim, Youngwon
Yoo, Seokha
Park, Sun-Kyung
Bae, Hansu
Lim, Young-Jin
Kim, Jin-Tae
author_facet Kim, Youngwon
Yoo, Seokha
Park, Sun-Kyung
Bae, Hansu
Lim, Young-Jin
Kim, Jin-Tae
author_sort Kim, Youngwon
collection PubMed
description BACKGROUND: Spondylolisthesis is a common degenerative spinal deformity. At the level of spondylolisthesis, the anatomy of the interlaminar space may differ from normal spine, in which case optimal angle of the needle insertion for spinal anesthesia may change. This study compared the optimal angle of needle insertion during spinal anesthesia in patients with and without lumbar spondylolisthesis using ultrasound. METHODS: We recruited 40 patients, 20 with and 20 without lumbar spondylolisthesis (group S and N, respectively). Ultrasonography was performed in the transverse midline and parasagittal oblique views at the spondylolisthesis level and the adjacent upper level. We measured the probe application angle with the longest interlaminar height of the ligamentum flavum-dura mater complex (LFD), depth from the skin to the LFD, depth from the skin to the anterior complex, and intrathecal space width. A positive angle represented a cephalad angulation. RESULTS: The optimal needle insertion angle in the transverse midline view at the spondylolisthesis level was (-) 2.7 ± 3.4° in group S and 0.8 ± 2.5° in group N (P [Formula: see text] 0.001). In the parasagittal oblique view, it was (-) 2.7 ± 4.5° in group S and 1.0 ± 3.2° in group N (P = 0.004). There were no between-group differences in the angles at the upper level, with all cephalad angles in both views. Other ultrasound image data were comparable between groups. CONCLUSION: In patients with spondylolisthesis, caudad angulation of the spinal needle can aid successful spinal puncture at spondylolisthesis level, both in the midline and paramedian approaches. TRIAL REGISTRATION: www.ClinicalTrials.gov (NCT04426916); registered 11 June 2020.
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spelling pubmed-84249092021-09-10 Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study Kim, Youngwon Yoo, Seokha Park, Sun-Kyung Bae, Hansu Lim, Young-Jin Kim, Jin-Tae BMC Anesthesiol Research BACKGROUND: Spondylolisthesis is a common degenerative spinal deformity. At the level of spondylolisthesis, the anatomy of the interlaminar space may differ from normal spine, in which case optimal angle of the needle insertion for spinal anesthesia may change. This study compared the optimal angle of needle insertion during spinal anesthesia in patients with and without lumbar spondylolisthesis using ultrasound. METHODS: We recruited 40 patients, 20 with and 20 without lumbar spondylolisthesis (group S and N, respectively). Ultrasonography was performed in the transverse midline and parasagittal oblique views at the spondylolisthesis level and the adjacent upper level. We measured the probe application angle with the longest interlaminar height of the ligamentum flavum-dura mater complex (LFD), depth from the skin to the LFD, depth from the skin to the anterior complex, and intrathecal space width. A positive angle represented a cephalad angulation. RESULTS: The optimal needle insertion angle in the transverse midline view at the spondylolisthesis level was (-) 2.7 ± 3.4° in group S and 0.8 ± 2.5° in group N (P [Formula: see text] 0.001). In the parasagittal oblique view, it was (-) 2.7 ± 4.5° in group S and 1.0 ± 3.2° in group N (P = 0.004). There were no between-group differences in the angles at the upper level, with all cephalad angles in both views. Other ultrasound image data were comparable between groups. CONCLUSION: In patients with spondylolisthesis, caudad angulation of the spinal needle can aid successful spinal puncture at spondylolisthesis level, both in the midline and paramedian approaches. TRIAL REGISTRATION: www.ClinicalTrials.gov (NCT04426916); registered 11 June 2020. BioMed Central 2021-09-08 /pmc/articles/PMC8424909/ /pubmed/34496754 http://dx.doi.org/10.1186/s12871-021-01444-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Kim, Youngwon
Yoo, Seokha
Park, Sun-Kyung
Bae, Hansu
Lim, Young-Jin
Kim, Jin-Tae
Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study
title Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study
title_full Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study
title_fullStr Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study
title_full_unstemmed Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study
title_short Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study
title_sort optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424909/
https://www.ncbi.nlm.nih.gov/pubmed/34496754
http://dx.doi.org/10.1186/s12871-021-01444-0
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