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Optimal patient position for lumbar puncture, measured by ultrasonography

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Abstract

The purpose of this study was to identify the patient position for lumbar puncture associated with the widest interspinous distance utilizing ultrasound. Sixteen healthy adult volunteers were placed in three positions commonly used for lumbar puncture (lateral recumbent with knees to chest, sitting and bent forward over an adjustable bedside stand, and sitting with feet supported and chest to knees) and the distance between lumbar spinous processes was measured by ultrasound. Measurements were compared between the three positions. Differences were analyzed using Tukey’s honestly significant difference test. The results showed that the interspinous distance was significantly greater in the “sitting, feet supported” position than in the other two positions (P<0.001). The “sitting, feet supported” position may offer advantages for selected patients undergoing lumbar puncture. Ultrasonography may be a useful adjunct when performing lumbar puncture in the emergency department.

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References

  1. Kooiker JC (1998) Spinal puncture and cerebrospinal fluid examination. In: Roberts JR, Hedges JR (eds) Clinical procedures in emergency medicine. Saunders, Philadelphia, pp 1054–1077

  2. Sternbach G (1985) Lumbar puncture. J Emerg Med 2:199–203

    CAS  PubMed  Google Scholar 

  3. Legg SJ, Gibbs V (1984) Measurement of the lumbar spinal canal by echo ultrasound. Spine 9:79–82

    PubMed  Google Scholar 

  4. Kamei K, Hanai K, Matsui N (1990) Ultrasonic level diagnosis of lumbar disc herniation. Spine 15:1170–1174

    CAS  PubMed  Google Scholar 

  5. Tervonen O, Lahde S, Vanharanta H (1991) Ultrasound diagnosis of lumbar disc degeneration. Comparison with computed tomography/discography. Spine 16:951–954

    CAS  PubMed  Google Scholar 

  6. Ferguson J, Brin M, Goldman R, et al (1998) Review of the literature on spinal ultrasound for the evaluation of back pain and radicular disorders: Report of the Threrapeutics and Technology Assessment subcommittee of the American Academy of Neurology. Neurology 51:343–344

    PubMed  Google Scholar 

  7. Cork RC, Kryc JJ, Vaughan RW (1980) Ultrasonic localization of the lumbar space. Anesthesiology 52:513–516

    CAS  PubMed  Google Scholar 

  8. Currie JM (1984) Measurement of the depth to the extradural space using ultrasound. Br J Anesth 56:345–347

    CAS  Google Scholar 

  9. Ledsome JR, Lessoway V, Susak LE, Gagnon FA, Gagnon R, Wing PC (1996) Diurnal changes in lumbar intervertebral distance, measured using ultrasound. Spine 21:1671–1675

    Article  CAS  PubMed  Google Scholar 

  10. Wallace DH, Currie JM, Gilstrap LC, Santos R (1992) Indirect sonographic guidance for epidural anesthesia in obese pregnant patients. Reg Anesth 17:233–236

    CAS  PubMed  Google Scholar 

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Acknowledgement

The authors are grateful to Polly Bijur, Ph.D., and Thomas Wendel, M.D., for their help with statistical analysis and for their insightful comments during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Emergency Medicine, Beth Israel Medical Center, First Avenue and 16th Street, New York, NY 10003, USA

    Marcelo Sandoval, William Shestak, Kai Stürmann & Carl Hsu

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  1. Marcelo Sandoval
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  2. William Shestak
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  3. Kai Stürmann
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  4. Carl Hsu
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Correspondence to Marcelo Sandoval.

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Sandoval, M., Shestak, W., Stürmann, K. et al. Optimal patient position for lumbar puncture, measured by ultrasonography. Emergency Radiology 10, 179–181 (2004). https://doi.org/10.1007/s10140-003-0286-3

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  • DOI: https://doi.org/10.1007/s10140-003-0286-3

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