Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, SAR, China.
Br J Radiol. 2012 Jul;85(1015):e262-9. doi: 10.1259/bjr/93508121. Epub 2011 Oct 18.
The use of ultrasound to guide peripheral nerve blocks is now a well-established technique in regional anaesthesia. However, despite reports of ultrasound guided epidural access via the paramedian approach, there are limited data on the use of ultrasound for central neuraxial blocks, which may be due to a poor understanding of spinal sonoanatomy. The aim of this study was to define the sonoanatomy of the lumbar spine relevant for central neuraxial blocks via the paramedian approach.
The sonoanatomy of the lumbar spine relevant for central neuraxial blocks via the paramedian approach was defined using a "water-based spine phantom", young volunteers and anatomical slices rendered from the Visible Human Project data set.
The water-based spine phantom was a simple model to study the sonoanatomy of the osseous elements of the lumbar spine. Each osseous element of the lumbar spine, in the spine phantom, produced a "signature pattern" on the paramedian sagittal scans, which was comparable to its sonographic appearance in vivo. In the volunteers, despite the narrow acoustic window, the ultrasound visibility of the neuraxial structures at the L3/L4 and L4/L5 lumbar intervertebral spaces was good, and we were able to delineate the sonoanatomy relevant for ultrasound-guided central neuraxial blocks via the paramedian approach.
Using a simple water-based spine phantom, volunteer scans and anatomical slices from the Visible Human Project (cadaver) we have described the sonoanatomy relevant for ultrasound-guided central neuraxial blocks via the paramedian approach in the lumbar region.
超声引导外周神经阻滞在区域麻醉中已得到广泛应用。然而，尽管有关于经旁正中入路行超声引导硬膜外穿刺的报道，但对于经旁正中入路行中枢神经轴阻滞的应用数据有限，这可能是由于对脊柱超声解剖结构的理解不足。本研究旨在通过旁正中入路确定与中枢神经轴阻滞相关的腰椎超声解剖结构。
通过“水基脊柱模型”、年轻志愿者和从可视人体项目数据集渲染的解剖切片，确定经旁正中入路进行中枢神经轴阻滞的腰椎超声解剖结构。
水基脊柱模型是研究腰椎骨性结构超声解剖结构的简单模型。在脊柱模型中，每个腰椎骨性结构在旁正中矢状扫描中产生“特征性模式”，与体内超声表现相似。在志愿者中，尽管声窗较窄，但在 L3/L4 和 L4/L5 腰椎椎间空间仍能很好地显示中枢神经结构的超声可见性，我们能够描绘出经旁正中入路行超声引导中枢神经轴阻滞的相关超声解剖结构。
我们通过使用简单的水基脊柱模型、志愿者扫描和可视人体项目（尸体）的解剖切片，描述了经旁正中入路在腰椎区域行超声引导中枢神经轴阻滞的相关超声解剖结构。
