Hospital de Base-FAMERP, Sáo José do Rio Preto, Sao Paulo, Brasil.
Anesth Analg. 2010 May 1;110(5):1494-5. doi: 10.1213/ANE.0b013e3181d5aca6. Epub 2010 Mar 19.
We investigated, with magnetic resonance imaging, the distance of the dura mater to the spinal cord in patients without spinal or medullar disease at the 2nd, 5th, and 10th thoracic segments.
Fifty patients in the supine position underwent magnetic resonance imaging. Medial sagittal slices of the 2nd, 5th, and 10th thoracic segments were measured for the relative distances using the 1.5-T superconducting system (Gyroscan Intera, Philips Medical Systems, Best, the Netherlands). In 10 patients, the angles relative to the tangent at the insertion point on the skin were measured.
The posterior dural-spinal cord distance is significantly greater at the midthoracic region (5th thoracic = 5.8 +/- 0.8 mm) than at the upper (2nd thoracic = 3.9 +/- 0.8 mm) and lower thoracic levels (10th thoracic = 4.1 +/- 1.0 mm) (P < 0.015). There were no differences between interspaces T2 and T10. There was no correlation between age and the measured distance between the dura mater and the spinal cord. The entry angle of the needle at T2 was 9.0 degrees +/- 2.5 degrees ; at T5, 45.0 degrees +/- 7.4 degrees ; and at T10, 9.5 degrees +/- 4.2 degrees .
This study demonstrated that there is greater depth of the posterior subarachnoid space at the T2, T5, and T10 levels. The greater distance was found at T5.
我们通过磁共振成像研究了无脊髓或神经疾病的患者在第 2、5 和 10 胸椎段的硬脑膜与脊髓之间的距离。
50 例患者取仰卧位，使用 1.5-T 超导系统（Gyroscan Intera，荷兰飞利浦医疗系统公司）对第 2、5 和 10 胸椎段的正中矢状位切片进行测量，以获得相对距离。在 10 例患者中，测量了相对于皮肤插入点切线的角度。
中胸段（第 5 胸椎=5.8±0.8mm）的硬脑膜-脊髓距离明显大于上胸段（第 2 胸椎=3.9±0.8mm）和下胸段（第 10 胸椎=4.1±1.0mm）（P<0.015）。T2 和 T10 之间的间隙没有差异。年龄与硬脑膜和脊髓之间测量的距离之间没有相关性。T2 进针角度为 9.0°±2.5°；T5 为 45.0°±7.4°；T10 为 9.5°±4.2°。
本研究表明，T2、T5 和 T10 水平的后蛛网膜下腔深度较大。在 T5 水平发现更大的距离。
