Generational Changes in Lumbar Spinal Canal Dimensions: Findings from a Sample U.S. Population

Tobin, Matthew K.; Gragnaniello, Cristian; Horwitz, Jack; Sun, Felicia W.; Schizas, Constantin; Neckrysh, Sergey

doi:10.1016/j.wneu.2020.11.039

Cited by 6 publications

(11 citation statements)

References 9 publications

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“…The study by American authors Tobin et al ( 12 ) was performed on the American population of Chicago residents (n=918) divided into two age groups, patients born between 1940-1949 (n=546) and patients born between 1970-1979 (n=372). We compared the results of our study with the group born in the period from 1970-1979, since patients from another age group (1940-1949) are older than the population covered by our research.…”

Section: Discussionmentioning

confidence: 99%

Morphometric Study of Lumbar Spinal Canal Dimensions in Bosnia and Herzegovina Population

Cizmic,

Hadziosmanovic,

Baljic

et al. 2023

Acta Inform Med

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Background: The lumbar spinal canal consists of 5 interconnected lumbar vertebrae through which the final part of the spinal cord passes and the lumbar and sacral spinal nerves that form the cauda equina. The lumbar canal stenosis can directly affect neurological symptoms and pain in the lumbar region and lower extremities. Due to the frequency of such symptoms, lumbar stenosis has been the subject of research around the world. Objective: The objective of this study was to measure, analyze and compare the mediosagital and interpeduncular diameters of the lumbar spinal canal in the population of Bosnia and Herzegovina to other populations around the world. Methods: We conducted a retrospective descriptive study on patients (n=200) who underwent Multi-slice computer tomography (MSCT) performed on a 40-slice CT scanner (Siemens Somatom Definition AS) for lumbar pain between January 1, 2013 and December 31, 2014. Age, gender, midsagittal (MSG) and interpeduncular (IP) diameters of the lumbar spine were recorded for each patient. Results: Results of our study show that the largest MSG diameter is at L1 level for both sexes, with an average length of 19,06mm, and the smallest at L3 level, with an average length of 16,66mm. Our study shows that the MSG diameter is significantly larger in females than males on all levels from L1 to L5. In both sexes, MSG diameter shows the form of an hourglass with narrowing at L3 level. IPD is largest at L5 level for both sexes, with an average length of 31,94mm, and the smallest average length at L1 level, at 24,78mm. IPD diameter is significantly larger in males than females on all levels from L1 to L5. IPD shows a tendency of growth from L1 to L5 in both sexes. Conclusion: There were significant differences in the dimensions of the lumbar spine canal between female and male patients. We found significant difference in MSG and IP diameters measurements between Bosnian and Herzegovinian population compared to other populations. The dimensions of the lumbar canal provide a baseline of normative data for the evaluation of patients presenting with lower back pain and lumbar canal stenosis in study population.

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Section: Discussionmentioning

confidence: 99%

Morphometric Study of Lumbar Spinal Canal Dimensions in Bosnia and Herzegovina Population

Cizmic,

Hadziosmanovic,

Baljic

et al. 2023

Acta Inform Med

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“…At the same time, it is especially suitable for residents with less experience. Because the insertion angle and depth of needle are easy to master.By reviewing previous literature [19][20][21] , for modi ed paramedian, the needle tip can reach subarachnoid space smoothly theoretically by setting 0.5 cm lateral to the midpoint of L3-4 spinous process space as injection site with the needle perpendicular to skin.A study showed that compared with median sagittal and transverse images, ultrasound scanning in para-midsagittal position could obtain a larger intervertebral space and a clearer eld of ligamentum avum and epidural vessels, thus improving the overall visibility of all structures [22] ,which indicated that modi ed paramedian technique might be bene cial for spinal anesthesia. In conclusion, modi ed paramedian for lumbar puncture is supported by relevant anatomical theories.…”

Section: Discussionmentioning

confidence: 99%

The exploration of ultrasound-assisted modified paramedian technique for spinal anesthesia in elderly

Shi

Zeng

Zheng

et al. 2022

Preprint

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Background:At present, there are two techniques which are widely applied clinically, including midline technique and paramedian technique,both of them are difficultfor residents when faced with elderly.We aim to explore the feasibility of ultrasound-assisted modified paramedian technique for spinal anesthesia in elderly,in order to provide clinicians with a new and easy-to-operate technique.Methods:A total of 150 elderly patients who were scheduled for urology surgery under spinal anesthesia in our hospital were randomly divided into three groups (n=50) : midline technique group ( group M), paramedian technique group ( group P) and modified paramedian technique group ( group PM) with 50 patients in each group.All spinal anesthesia were performed by the same second-year resident.Results:Compared with groups M and P , group PM had a significantly higher first-attempt success rate (P<0.05,specially in patients aged 65-74 years)，fewer attempts（P<0.05）and higher patient satisfaction score（P<0.05）. Compared with group M,the time taken to perform spinal anesthesia and the number of needle redirections were significantly reduced in group PM (P<0.05), and there was no statistically significant difference between groups PM and P . There were no statistically significant differences in the cases of inconsistency between ultrasound-assisted and landmark-guided location of intervertebral space, the time taken to ultrasound-assisted location,the onset time to pain block at T10,the incidence of hypotension ,anesthesia effect and the incidence of headache, low back pain, nausea and vomiting within 24 hours after surgery.Conclusions: The modified paramedian technique in spinal anesthesia for elderly patients can significantly improve the first-attempt success rate, reduce the number of attempts and reduce procedure time and the damage to patients’ tissue during operation. Compared with the traditional midline and paramedian techniques, modified paramedian technique achieves complementary advantages of the others,easy to learn,which effectively solves the difficulty of spinal anesthesia during the procedure in elderly patients and provides a new operation path for lumbar puncture.It is worthy of further research and application.Trial registration:Prospectively registered at China Clinical Trial Registry, registration number ChiCTR2100047635, date of registration: 21/06/2021.

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“…At the same time, it is especially suitable for residents with less experience since the insertion angle and the depth of the needle are easy to master. Previous studies [17][18][19] have shown that in the modified paramedian technique the needle tip can theoretically reach the subarachnoid space smoothly by setting the injection site 0.5 cm lateral to the midpoint of the L3-4 spinous process space with the needle perpendicular to skin.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-assisted modified paramedian technique for spinal anesthesia in elderly

et al. 2022

View full text Add to dashboard Cite

Background At present, there are two techniques which are widely applied clinically; the midline and the paramedian. Both methods are difficult for clinicians when treating the elderly. The aim of this work is to explore the feasibility of an ultrasound-assisted modified paramedian technique for spinal anesthesia in the elderly. This would provide clinicians with a new and easy-to-operate technique. Methods A total of 150 elderly patients who were scheduled for urology surgery under spinal anesthesia in our hospital were randomly divided into three groups (n = 50): (i) midline technique group (group M), (ii) paramedian technique group (group P), and (iii) modified paramedian technique group (group PM). All spinal anesthesia were performed by the same second-year resident. Results Compared with groups M and P, group PM had significantly higher first-attempt success rate (P < 0.05, especially in patients aged 65-74 years), fewer attempts (P < 0.05), and higher patient satisfaction score (P < 0.05). Compared with group M, the time taken to perform spinal anesthesia and the number of needle redirections were significantly reduced in group PM (P < 0.05). There was no statistically significant difference between groups PM and P. There were also no statistically significant differences in the cases of inconsistency between ultrasound-assisted and landmark-guided location of intervertebral space, the time taken to ultrasound-assisted location, the onset time to pain block at T10, the incidence of hypotension, anesthesia effect and the incidence of headache, lower back pain, or nausea and vomiting, within 24 h after surgery. Conclusions The modified paramedian technique in spinal anesthesia for elderly patients can significantly improve the first-attempt success rate, reduce both the number of attempts and procedure time, and minimize tissue damage during the operation. Compared with the traditional techniques, the modified paramedian technique combines the advantages of both the midline and the paramedian methods, and is easy to learn. It is worthy of further research and application. Trial registration Prospectively registered at the China Clinical Trial Registry, registration number ChiCTR2100047635, date of registration: 21/06/2021.

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Generational Changes in Lumbar Spinal Canal Dimensions: Findings from a Sample U.S. Population

Cited by 6 publications

References 9 publications

Morphometric Study of Lumbar Spinal Canal Dimensions in Bosnia and Herzegovina Population

Morphometric Study of Lumbar Spinal Canal Dimensions in Bosnia and Herzegovina Population

The exploration of ultrasound-assisted modified paramedian technique for spinal anesthesia in elderly

Ultrasound-assisted modified paramedian technique for spinal anesthesia in elderly

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