Identification of thoracic intervertebral spaces by means of surface anatomy: a magnetic resonance imaging study

Background:  Successful thoracic epidural analgesia depends on the sensory blockage of specific dermatomes following appropriate placement of the epidural catheter. This study aimed to ascertain how accurately anaesthesiologists identify thoracic intervertebral spaces, and whether counting from the prominent vertebra is easier than using the iliac crest as an anatomical landmark.

[1]  F. Ievins.  Accuracy of placement of extradural needles in the L3-4 interspace: comparison of two methods of identifying L4. , 1991, British journal of anaesthesia.

[2]  S. Dolin,et al.  Radiographic guided epidural placement , 2003, Anaesthesia.

[3]  D. Wilson,et al.  Ability of anaesthetists to identify a marked lumbar interspace. , 2000, Anaesthesia.

[4]  Q. Hogan.  Tuffier's line: the normal distribution of anatomic parameters. , 1994, Anesthesia and analgesia.

[5]  P. Magnus,et al.  Rapid changes in the prevalence of obesity and known diabetes in an adult Norwegian population. The Nord-Trøndelag Health Surveys: 1984-1986 and 1995-1997. , 1999, Diabetes care.

[6]  S. C. Lee,et al.  Coiling of lumbar epidural catheters , 2002, Acta anaesthesiologica Scandinavica.

[7]  C. Render.  The reproducibility of the iliac crest as a marker of lumbar spine level , 1996, Anaesthesia.

[8]  Q. Hogan.  Epidural catheter tip position and distribution of injectate evaluated by computed tomography. , 1999, Anesthesiology.

[9]  M J Watson,et al.  Could ultrasonography be used by an anaesthetist to identify a specified lumbar interspace before spinal anaesthesia? , 2003, British journal of anaesthesia.

[10]  L. Arendt-Nielsen,et al.  Lumbar epidural fentanyl: segmental spread and effect on temporal summation and muscle pain. , 2003, British journal of anaesthesia.

[11]  A. Forster,et al.  Continuous spinal anesthesia: where do spinal catheters go? , 1993, Anesthesia and analgesia.

[12]  G Furness,et al.  An evaluation of ultrasound imaging for identificationof lumbar intervertebral level , 2002, Anaesthesia.

[13]  T. Johnson,et al.  Radiographic guided epidural placement , 2003, Anaesthesia.

[14]  C. Keller,et al.  Accuracy in estimating the correct intervertebral space level during lumbar, thoracic and cervical epidural anaesthesia , 2004, Acta anaesthesiologica Scandinavica.

[15]  J. Bahk,et al.  Influence of Age and Sex on the Position of the Conus Medullaris and Tuffier's Line in Adults , 2003, Anesthesiology.