Effect of Position on Ultrasonographic Measurement of Ligamentum Flavum Length of Lumbar Intervertebral Space in the Elderly Patients

Huiming WEI; Zhigui LI; Lingling WANG; Lin CAO; Yi YAN

doi:10.12259/j.issn.2095-610X.S20220422

Volume 43 Issue 4

Apr. 2022

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Huiming WEI, Zhigui LI, Lingling WANG, Lin CAO, Yi YAN. Effect of Position on Ultrasonographic Measurement of Ligamentum Flavum Length of Lumbar Intervertebral Space in the Elderly Patients[J]. Journal of Kunming Medical University, 2022, 43(4): 107-111. doi: 10.12259/j.issn.2095-610X.S20220422

Citation:

Huiming WEI, Zhigui LI, Lingling WANG, Lin CAO, Yi YAN. Effect of Position on Ultrasonographic Measurement of Ligamentum Flavum Length of Lumbar Intervertebral Space in the Elderly Patients[J]. Journal of Kunming Medical University, 2022, 43(4): 107-111. doi: 10.12259/j.issn.2095-610X.S20220422

Citation:

Huiming WEI, Zhigui LI, Lingling WANG, Lin CAO, Yi YAN. Effect of Position on Ultrasonographic Measurement of Ligamentum Flavum Length of Lumbar Intervertebral Space in the Elderly Patients[J]. Journal of Kunming Medical University, 2022, 43(4): 107-111. doi: 10.12259/j.issn.2095-610X.S20220422

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Effect of Position on Ultrasonographic Measurement of Ligamentum Flavum Length of Lumbar Intervertebral Space in the Elderly Patients

doi: 10.12259/j.issn.2095-610X.S20220422

Dept. of Anesthesiology, The 920 Hospital of Joint Service Support Army of PLA, Kunming Yunnan 650032, China

Received Date: 2022-01-01
Available Online: 2022-03-23
Publish Date: 2022-04-25

Abstract

Abstract

Objective To investigate effect of body position on ultrasonographic measurement of ligamentum flavum lengthin lumbar intervertebral space in the elderly patients. Methods 40 patients over 65 years of age who underwent spinal anesthesia were selected to examine the L 3/4, L 4/5 and L 5 / S1 intervertebral spaces. Anterioredge length oftheligamentum flavum （ALL） and distance from skin to theligamentum flavum （DSL） of L3/4, L4/5 and L5/S1 intervertebral spaces were measured by ultrasonic parasagittal oblique view in both sitting and left lateral decubitus position, and definition degree of each ultrasonic image were analyzed. Results Compared with the measurement in left lateral position, ALL at L5/S1 level in sitting position was longer, and longer than that at L3/4 in the same position （P < 0.05）; DSL at L5/S1 was lower than that at L3/4 in sitting position （P < 0.05）. Compared with ultrasonic definition of L5/S1, the fine definition rate of the left and right sides of L3/4 and L4/5 in both positions was lower （P < 0.05） . Conclusion The ALL ultrasonic measurement at L5/S1 level in sitting position was longer than that in left lateral decubitus position, and also longer than that at L3/4 and L4/5 in the same position, its depth and image were shallower and clearer than other spaces. It is recommended for elderly patients to use the paramidian puncture approach for lumbar anesthesia. The relatively shallow width of L5/ S1 should be selected under the sitting position, and the left and right sides are equivalent, especially under the guidance of ultrasound.
- Position,
- Elderly,
- Ligamentum flavum,
- Ultrasonography

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References(17)

References

[1]	Tang Z,Zhang C,Xu Z,et al. Observation of single spinal anesthesia by 25G needle puncture through a lateral crypt for hip surgery in elderly patients[J]. Medicine (Baltimore),2019,98(27):16334.
[2]	Hulmani D,Garg B,Mehta N,et al. Morphological changes in the ligamentum flavum in degenerative lumbar canal stenosis:A prospective,comparative study[J]. Asian Spine J,2020,14(6):773-781. doi: 10.31616/asj.2020.0041
[3]	Rabinowitz A,Bourdet B,Minville V,et al. The paramedian technique:A superior initial approach to continuous spinal anesthesia in the elderly[J]. Anesth Analg,2007,105(6):1855-1857. doi: 10.1213/01.ane.0000287655.95619.fa
[4]	Park S K,Yoo S,Kim W H,et al. Ultrasound-Assisted vs. landmark-guided paramedian spinal anaesthesia in the elderly:A randomised controlled trial[J]. Eur J Anaesthesiol,2019,36(10):763-771. doi: 10.1097/EJA.0000000000001029
[5]	Elsharkawy H,Maheshwari A,Babazade R,et al. Real-time ultrasound guided spinal anesthesia in patients with predicted difficult anatomy[J]. Minerva Anestesiol,2017,83(5):465-473.
[6]	Bae J,Park S K,Yoo S,et al. Influence of age,laterality,patient position,and spinal level on the interlamina space for spinal puncture[J]. Reg Anesth Pain Med,2020,45(1):27-31. doi: 10.1136/rapm-2019-100980
[7]	Kallidaikurichi S K,Iohom G,Loughnane F,et al. Conventional landmark-guided midline versus preprocedure ultrasound-guided paramedian techniques in spinal anesthesia[J]. Anesth Analg,2015,121(4):1089-1096. doi: 10.1213/ANE.0000000000000911
[8]	Chin K J,Ramlogan R,Arzola C,et al. The utility of ultrasound imaging in predictingease of performance of spinal anesthesia in an orthopedic patient population[J]. Reg Anesth Pain Med,2013,38(1):34-38.
[9]	Xu C S,Qu X D,Qu Z J,et al. Effect of subarachnoid anesthesia combined with propofol target-controlled infusion on blood loss and transfusion for posterior total hip arthroplasty in elderly patients[J]. Chin Med J (Engl),2020,133(6):650-656.
[10]	陈燕,何亮,衡新华. 椎管内麻醉后神经并发症600例分析[J]. 昆明医学院学报,2011,32(11):99-102.
[11]	Vogt M,Van Gerwen D J,Lubbers W,et al. Optimal point of insertion and needle angle in neuraxial blockade using a midline approach:A study in computed tomography scans of adult patients[J]. Reg Anesth Pain Med,2017,42(5):600-608. doi: 10.1097/AAP.0000000000000653
[12]	Kim H,Won D,Chang J E,et al. Ultrasound assessment of the anatomic landmarks for spinal anesthesia in elderly patients with hip fracture:A prospective observational study[J]. Medicine (Baltimore),2019,98(27):16388.
[13]	费昱达,崔旭蕾. 超声引导下老年患者硬膜外穿刺二例[J]. 临床麻醉学杂志,2018,34(1):98-99.
[14]	Srinivasan K K,Leo A M,Iohom G,et al. Pre-procedure ultrasound-guided paramedian spinal anaesthesia at L5-S1:Is this better than landmark-guided midline approach? A randomised controlled trial[J]. Indian J Anaesth,2018,62(1):53-60. doi: 10.4103/ija.IJA_448_17
[15]	Da Silva L C,Pacheco P F,Sellera F P,et al. The use of ultrasound to assist epidural injection in obese dogs[J]. Vet Anaesth Analg,2020,47(1):137-140. doi: 10.1016/j.vaa.2019.10.003
[16]	Soni P,Punj J. Ultrasound-guided lumbar transforaminal epidural injection:A narrative review[J]. Asian Spine J,2021,15(2):261-270. doi: 10.31616/asj.2019.0245
[17]	Di Filippo A,Falsini S,Adembri C. Minimum anesthetic volume in regional anesthesia by using ultrasound-guidance[J]. Braz J Anesthesiol,2016,66(5):499-504. doi: 10.1016/j.bjan.2014.05.007

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