Inter-rater Accuracy and Reliability of a Palpation Protocol of the C7 Spinous Process Comprising a Combination of 3 Traditional Palpation Techniques

Albuquerque, Priscila Maria Nascimento Martins de; Silva, Ericka P.C. Da; Melo, Thania Maion de Souza; Montenegro, Eduardo José Nepomuceno; Oliveira, Daniella Araújo de; Guerino, Marcelo Renato; Silva, Gisélia Alves Pontes da

doi:10.1016/j.jmpt.2022.06.001

Cited by 1 publication

(2 citation statements)

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“…Cervical palpation has multiple marker points and excellent inter-rater reliability in identifying the C7 spinous process 4 .However, increased body weight and soft tissue thickness in the neck were associated with inaccurate palpation, respectively, and prominent among the anatomical variables was the fact that C7 was not always the most prominent vertebra, occurring in only 60-70% of the population 4 . Weight gain and dorsal cervical fat pads were associated with errors and palpation inaccuracy respectively.…”

Section: Spinal Level Estimationmentioning

confidence: 99%

“…There is anatomical variability in palpation of C7 in the cervical spine, with C7 not always being the most prominent vertebra, occurring in only 60-70% of the population. In 30% to 40% of the population, T1 may be the longest vertebra in the vertebral column 4 . On lateral exion and extension x-rays of the cervical spine in the standing position, the main corresponding cervical levels of the mandibular angle were C2 in both exion and extension, the hyoid bone was C3-C4 gap in exion and C3 in extension, the thyroid cartilage was C5 in both exion and extension, and the cricoid cartilage was C6 in exion and C5-C6 gap in extension 5,6 .…”

Section: Introductionmentioning

confidence: 99%

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The significance of palpation of the lowest point of the rib in the posterior axillary line for spinal surgery

Liu

Yang

et al. 2023

Preprint

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Objective: The aim of this study was to identify the feasibility of using palpation of the lowest point of the rib in the posterior axillary line to identify the segment of the spine during spinal surgery. Methods: Three orthopedic surgeons examined 101 patients and determined, by blind palpation, the lowest point of the ribs that could be reached at the posterior axillary line, placed a radiolucent marker, made a plumb line through this point and intersected it at one point C. From this point, a line was made at an angle of 45° to the plumb line and intersected the posterior midline at another point B, where the markers were placed. A posterior anterior lumbar spine X-ray was then taken. Three orthopedic surgeons then identified the spine segment by radiography and assessed the agreement with the spine segment identified by imaging (kappa coefficient). Results: Point B is most commonly found in the T12 and T11 vertebrae, with an accuracy rate of 86% (87/101).Point C, most commonly at the L3 vertebral body, was 79% (80/101) accurate. The greatest proportion of these was in the upper third of L3. High consistency of results between right and left side on palpation. Conclusions: In the prone position, clinicians can use this method as a measurement tool with good reliability for palpating the thoracolumbar vertebrae, but the spinal level estimated by palpation may be inadvertently affected by examiner skill and anatomical variation, as well as by issues of individual variation.

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Section: Spinal Level Estimationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%