Reliability of Tuffier’s line evaluated on cadaver specimens

Windisch, G.; Ulz, H.; Feigl, Georg

doi:10.1007/s00276-009-0493-z

Cited by 23 publications

(15 citation statements)

References 12 publications

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“…MR imaging studies demonstrated that the Tuffier's line were in a significantly lower position in females compared to males in adults [4,8]. A similar result demonstrated by Windisch et al in a cadaveric study [9]. Shiraishi et al who found that the intercristal line passes through the body and lower one-third of L4 in men and the body and upper one-third of L5 in women [10].…”

Section: Discussionsupporting

confidence: 66%

Radiological Evaluation of the Tuffier’s Line in Pediatric Patients

Sargın¹,

Uluer²,

Tutar³

et al. 2016

Ann Clin Anal Med

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ÖzetAmaç: Tuffier çizgisi her iki iliak kristanın en yüksek noktalarının birleştiği hat olarak tanımlanmakta olup genellikle L4 vertebra gövdesinden yada L4-5 vertebral aralıktan geçmektedir. Bu çalışmada Tuffier çizgisinin pediatrik popülasyonda yaş ve cinsiyetle değişimi radyolojik olarak değerlendirilmiştir. Gereç ve Yöntem: Bu çalışmada 16 yaş ve daha küçük 519 hastanın ayakta antero-posterior lomber radyografileri retrospektif olarak değerlendirilmiştir. Değerlendirme şu sıradaki gibi yapıldı: L4 vertebra gövdesi , L4 inferior endplate, L4-L5 disk aralığı, L5 superior endplate, L5 vertebra gövdesi, L5 inferior endplate, L5-S1 disk aralığı.Hastaların cinsiyet, yaş ve Tuffier çizgile-rinin vertebral seviyeleri kaydedildi. Veriler ki-kare testi ile analiz edilmiştir. Bulgular: 315 erkek ve 204 kadın hasta vardı.Tuffier hattı düzeyinde kadın ve erkekler arasında anlamlı bir fark yoktu (p=0.102). Hem erkek hem de kadın gruplarında Tuffier hattı L5 vertebra gövdesinden geçme eğilimindeydi, sıra-sıyla% 44.8 ve% 46.1. Tuffier hattı düzeyinde yaş grupları arasında anlamlı bir fark yoktu (p<0.001). Tuffier çizgisi yaşla birlikte anlamlı olarak yükselme eğilimindeydi. Tartışma: Erkeklerle kıyaslandığında Tuffier çizgisinin kızlarda benzer olduğu ve genç yaş gruplarında önemli ölçüde daha düşük bir konumda olduğu bu çalışmada gösterilmiştir. Tuffier çizgisi pediatrik hastalarda artan yaş ile birlikte anlamlı olarak yükselme göstermektedir. Anahtar KelimelerTuffier Çizgisi; Kristalar Arası Hat; Pediatrik; Yaş; Cinsiyet Abstract Aim: Tuffier's Line (Intercristal line) is defined as the line connecting the highest points of both iliac crests which generally passes through either the body of the L4 vertebra or the intervertebral space between L4-5 vertebrae. In this study, we assessed the radiological evaluation of the level of Tuffier's line with changes in age and gender in pediatric population. Material and Method: In this study, standing anteroposterior lumbar radiographs of 519 patients aged 16 and younger were analyzed retrospectively. Notation was made as to the intersection of this line with one of the following structures: L4 vertebral body, L4 inferior endplate, L4-L5 disc space, L5 superior endplate, L5 vertebral body, L5 inferior endplate, L5-S1 disc space. Patients' gender, age and vertebral level of the Tuffier's line are recorded. Data is analyzed with chi-square test. Results: There were 315 male and 204 female patients.There were no significant difference between females and males on the level of Tuffier's line (p=0.102). In both male and female groups Tuffier's line tended to pass through the L5 vertebral body, respectively 44.8 % and 46.1 %. There was a significant difference between age groups on the level of Tuffier's line (p<0.001). Tuffier's line were significantly increased with ascending ages. Discussion: This study clearly demonstrated that the Tuffier's line were in a similar position in females compared to males and also Tuffier's line were in a significantly lower position in younger age groups...

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Section: Discussionsupporting

confidence: 66%

Radiological Evaluation of the Tuffier’s Line in Pediatric Patients

Sargın¹,

Uluer²,

Tutar³

et al. 2016

Ann Clin Anal Med

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“…Both conus medullaris and Tuffier's line have been reported to be placed slightly lower down more frequently in females than in males [9]. To date we are unaware of any study demonstrating gender differences in the conus-Tuffier's line distance.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Reliability of Anatomic Landmarks in Safe Lumbar Puncture Using Magnetic Resonance Imaging: Does Sex Matter?

Rahmani

Bozorg

Esfe

et al. 2011

International Journal of Biomedical Imaging

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Aim. To determine the level of the conus medullaris-Tuffier's line, and conus medullaris-Tuffier's line distance using imaging and evaluate their relation to age and gender. Methods. We performed a cross-sectional study of 189 adult participants, who underwent MR imaging of lumbosacral spine. Each vertebra was divided into 3 equal segments (upper, middle, and lower), and intervertebral disc space was also assumed as one segment. All segments from T12 upper segment to L5S1 intervertebral disc were numbered consecutively. The position of conus medullaris and Tuffier's line was determined by the vertebral segment or intervertebral disc space at the same level. The patients were stratified into high/low conus medullaris position (cutpoint: L1 middle segment) and short/long conus-Tuffier's distance (cutpoint: 14 segments). Results. Women with low conus were significantly more than men, in patients older than 50 years old (72.7% in females versus 55.3% in males; P < .05), whereas there was not such a sexual dimorphism in patients younger than 50 years old. Similarly, short conus-Tuffier's distance was more frequent among women than men in patients older than 50 years old (59.7% in females versus 39.5% in males; P < .05), whereas there was not any gender difference in patients younger than 50 years old. Conus-Tuffier's distance was negatively correlated with age (r = −0.32, P < .001) in all studied population. Conclusion. Anatomical landmarks vary according to age and gender, with a lower end of conus medullaris in women, so clinicians should use more caution on the identification of the appropriate site for lumbar puncture, particularly in elderly women.

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“…In the study, the Tuffier line in females in the control group with no fracture was determined at lower levels. In a study of 58 cadavers by Windisch et al, it was reported that the Tuffier line in females was usually at a lower level than that of males [11]. It has been reported that the Tuffier line is at a lower level in females than in males, independently of age, as the anatomic structure of the pelvic bones of females is different from that of males [12].…”

Section: Discussionmentioning

confidence: 99%

A tomographic evaluation of the tuffier line in patients with hip fracture

Bilal¹

2018

Ann Clin Anal Med

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Aim: The aim of this study was to compare the vertebral level of the Tuffier line in patients with hip fracture with the level in a control group using computed tomography (CT) examination, and to determine whether or not the Tuffier line changed location according to age and gender. Material and Method: CT images were examined of 55 patients aged >18 years with hip fracture who presented at the Orthopaedics Clinic and of 55 patients as a control group who had lumbar CT taken for any other reason. Results: A total of 110 patients were included in the study, comprising 46 males and 64 females. The Tuffier line was determined at higher levels in the patients with hip fracture compared to the control group (p=0.006). While there was no significant relationship between gender and level in the hip fracture group (p=0.579), the Tuffier line was determined to be at lower levels in the females of the non-fracture group (p=0.000). Discussion: The results of this study showed that in hip fracture patients there could be a change according to age and gender. In particular, as the Tuffier line in hip fracture patients crosses a higher vertebral level compared to the normal population, to reduce the complication rate in the application of neuroaxial anaesthesia, it would be more appropriate to use auxiliary methods additional to the Tuffier line when determining the entry point.

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Reliability of Tuffier’s line evaluated on cadaver specimens

Cited by 23 publications

References 12 publications

Radiological Evaluation of the Tuffier’s Line in Pediatric Patients

Radiological Evaluation of the Tuffier’s Line in Pediatric Patients

Evaluating the Reliability of Anatomic Landmarks in Safe Lumbar Puncture Using Magnetic Resonance Imaging: Does Sex Matter?

A tomographic evaluation of the tuffier line in patients with hip fracture

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