Using Body Mass Index to Predict Needle Length in Fluoroscopy-Guided Lumbar Punctures

Nayate, Ameya; Nasrallah, Ilya M.; Schmitt, J. Eric; Mohan, Suyash

doi:10.3174/ajnr.a4579

Cited by 10 publications

(9 citation statements)

References 19 publications

(28 reference statements)

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“…The formulae (Fig 3) derived from our study differ from that which has been reported previously by a different group 8 . A potential explanation for this is the difference in average BMI per study.…”

Section: Discussioncontrasting

confidence: 89%

“…The formulae (Fig 3) derived from our study differ from that which has been reported previously by a different group. 8 A potential explanation for this is the difference in average BMI per study. Our cohort contained a greater proportion of patients with BMIs classified as normal or overweight (39.6% and 30.1% vs. 22% and 22%, respectively) and a smaller proportion of patients with BMIs classified as obese (25.7% vs. 52%).…”

Section: Discussionmentioning

confidence: 99%

“…Our cohort contained a greater proportion of patients with BMIs classified as normal or overweight (39.6% and 30.1% vs. 22% and 22%, respectively) and a smaller proportion of patients with BMIs classified as obese (25.7% vs. 52%). Additionally, the measurements from the earlier study 8 were made using the lateral oblique and craniocaudal oblique approaches that inherently result in deeper measurements than those made with the sagittal approach. Our findings can help guide providers in their selection of an appropriate needle length for bedside LP.…”

Section: Discussionmentioning

confidence: 99%

“…The skin to spinal canal distance (SCD) is an important variable that, if accurately predicted prior to LP, can help minimize complications. Previously, Nayate et al 8 published a formula based on computed tomography (CT) and magnetic resonance imaging (MRI) to predict the required needle length in a cohort of 45 patients. Hazarika et al 9 similarly reported on the variation in SCD among a cohort of males, nonpregnant females, and parturient females ( n = 100 each).…”

Section: Introductionmentioning

confidence: 99%

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Body Mass Index Correlates with Skin to Spinal Canal Distance: A Large Retrospective Single‐Center Study

Mahmoudi

Joon

Kihira

et al. 2020

Journal of Neuroimaging

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BACKGROUND AND PURPOSE: Despite increasing demand for fluoroscopy-guided lumbar puncture (FG-LP), there is limited quantitative and epidemiological data on patients undergoing this procedure. Additionally, data are scarce on the correlation of iliac crest landmarks to the actual anatomical lumbar level (intercristal line). The aim of this study is to determine if (1) body mass index (BMI) correlates with skin to spinal canal distance (SCD) and (2) the iliac crest landmark correlates with the presumed anatomical landmark on cross-sectional imaging. METHODS: In this retrospective, single-center IRB-approved study, we assessed 495 patients who underwent FG-LP and had lumbar computed tomography/magnetic resonance imaging within 6 months of presentation. SCD was measured on the sagittal view at the L3-L4, L4-L5, and L5-S1 intervertebral levels. RESULTS: In our cohort of 495 adults (mean age ± standard deviation [SD], 53.2 ± 16.4 years), there was a statistically significant linear correlation between BMI and SCD at each intervertebral level. Mean ± SD (R 2) SCD at L3-4, L4-5, and L5-S1 was 6.7 ± 1.6 cm (.5486), 7.4 ± 1.9 cm (.5894), and 7.8 ± 1.9 cm (.5968), respectively. The intercristal line aligned with L3-L4, L4-L5, and L5-S1 in 2.1%, 72.4%, and 6.2% of patients, respectively. CONCLUSIONS: There was direct, positive linear correlation between BMI and SCD at clinically relevant lumbar disc levels. Furthermore, there is considerable anatomical variance in the intervertebral space that aligns with the superior aspect of the iliac crest.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Body Mass Index Correlates with Skin to Spinal Canal Distance: A Large Retrospective Single‐Center Study

Mahmoudi

Joon

Kihira

et al. 2020

Journal of Neuroimaging

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“…Anthropometric data included age, gender, height, weight, calf dominance and BMI [22]. Further, calf length (measured from the popliteal fossa to the calcaneal tuberosity) and calf girth (assessed in the mid-third and distal-third distance of the calf length) were also calculated (Figure 1).…”

Section: Participantsmentioning

confidence: 99%

Prediction Model of Soleus Muscle Depth Based on Anthropometric Features: Potential Applications for Dry Needling

Valera‐Calero

Laguna-Rastrojo²,

de-Jesús-Franco

et al. 2020

Diagnostics

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This study was conducted to investigate if anthropometric features can predict the depth of the soleus muscle, as assessed with ultrasound imaging, in a sample of healthy individuals to assist clinicians in the application of dry needling. A diagnostic study to calculate the accuracy of a prediction model for soleus muscle depth, as assessed with ultrasonography, in the middle-third and distal-third of the calf, based on anthropometric features such as age, height, weight, body mass index (BMI), calf length, mid-third and distal-third calf girth, was conducted on 48 asymptomatic healthy subjects (75% male) involving a total of 96 calves. Multiple linear regression analyses were used to determine which variables contributed significantly to the variance in the soleus muscle depth at middle-third and distal-third of the calf by gender. Women were found to have a deeper soleus muscle than men (p < 0.001). Weight, height, BMI, and mid-third calf perimeter explained 69.9% of variance in men, whereas mid-third calf perimeter, calf length, height, and distal-third calf girth explained 73% of the variance in women of the distal-third soleus depth (p < 0.001). Additionally, mid-third calf girth and calf length explained 28.8% of variance in men, whereas mid-third calf perimeter, calf length, and weight explained 67.8% of variance in women of the mid-third soleus depth (p < 0.001). This study identified anthropometric features that predict soleus muscle depth, as assessed with ultrasound, in asymptomatic individuals, but these features are different in men and women. Our findings could assist clinicians in choosing the proper length of the needle to avoiding passing through the soleus during dry needling.

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State‐of‐the‐art of lumbar puncture and its place in the journey of patients with Alzheimer's disease

Hampel

Shaw

Aisen

et al. 2021

Alzheimer's & Dementia

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Recent advances in developing disease-modifying therapies (DMT) for Alzheimer's disease (AD), and the recognition that AD pathophysiology emerges decades before clinical symptoms, necessitate a paradigm shift of health-care systems toward biomarker-guided early detection, diagnosis, and therapeutic decision-making. Appropriate incorporation of cerebrospinal fluid biomarker analysis in clinical practice is an essential step toward system readiness for accommodating the demand of AD diagnosis and proper use of DMTs-once they become available. However, the use of lumbarThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Using Body Mass Index to Predict Needle Length in Fluoroscopy-Guided Lumbar Punctures

Cited by 10 publications

References 19 publications

Body Mass Index Correlates with Skin to Spinal Canal Distance: A Large Retrospective Single‐Center Study

Body Mass Index Correlates with Skin to Spinal Canal Distance: A Large Retrospective Single‐Center Study

Prediction Model of Soleus Muscle Depth Based on Anthropometric Features: Potential Applications for Dry Needling

State‐of‐the‐art of lumbar puncture and its place in the journey of patients with Alzheimer's disease

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