Li Ping, Luo Dong, Qu Haibo, Li Xuesheng, Luo Linli
Department of Anesthesiology, West China Second University Hospital, Sichuan University, 20#, Section 3 Renmin Nan Road, Chengdu, Sichuan, 610041, PR China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, PR China.
BMC Pregnancy Childbirth. 2024 Dec 31;24(1):888. doi: 10.1186/s12884-024-07113-7.
While the line joining the posterior superior iliac spine (PSIS) intersects a relatively stable sacral vertebra, it does not directly facilitate the localization of lumbar interspace or assist in the positioning for neuraxial anesthesia. Our study aimed to explore the potential of the PSIS line as a reference point and to determine its practical applicability in clinical settings.
We consecutively enrolled pregnant women with gestational ages ranging from 24 to 38 weeks scheduled for magnetic resonance imaging (MRI) examination. Two anesthesiologists used ink to mark the PSIS line through visual localization or palpation. Subsequently, an equilateral triangle was constructed with the PSIS line as the baseline, with the vertex intersected the lumbar spine towards the head. Marker capsules were then affixed to the vertex of PSIS-line-based triangle and PSIS line, and MRI was performed with participants in the supine position. The vertebral body or interspinous space intersected by the PSIS line and vertex was recorded.
One hundred parturients were analyzed. The PSIS line intersected the L5 vertebral body, L5-S1 interspinous space, S1 vertebral body, S2 vertebral body, and S3 vertebral body in 11, 10, 62, 15, and 2 cases, respectively. Furthermore, the vertex of PSIS-line-based triangle intersected the L2 vertebral body, L2-3 interspinous space, L3 vertebral body, L3-4 interspinous space, and L4 vertebral body in 4, 7, 53, 20, and 16 cases, respectively. No significant correlation was detected between the vertebral levels intersected of the PSIS line and the parameters of height, weight, and gestational age.
The PSIS line commonly intersects S1 vertebral body, and vertebral levels intersected of the PSIS-line-based vertex rang from L2 to L4 vertebral body in pregnant women. The PSIS-line-based triangle has potential to aid identification of vertebral levels, which could be applied to neuraxial anesthesia.
The study was registered in Chinese Clinical Trials Registry(Ref. ID: ChiCTR-DDD-16010067).
虽然连接后上棘（PSIS）的线与一个相对稳定的骶椎相交，但它并不能直接有助于定位腰椎间隙或辅助进行神经轴麻醉的定位。我们的研究旨在探索PSIS线作为参考点的潜力，并确定其在临床环境中的实际适用性。
我们连续纳入了计划进行磁共振成像（MRI）检查、孕周在24至38周之间的孕妇。两名麻醉医生通过视觉定位或触诊用墨水标记PSIS线。随后，以PSIS线为基线构建一个等边三角形，其顶点朝着头部与腰椎相交。然后将标记胶囊固定在基于PSIS线的三角形的顶点和PSIS线上，让参与者仰卧位进行MRI检查。记录PSIS线和顶点相交的椎体或棘突间隙。
对100名产妇进行了分析。PSIS线分别与L5椎体、L5-S1棘突间隙、S1椎体、S2椎体和S3椎体相交的情况有11例、10例、62例、15例和2例。此外，基于PSIS线的三角形的顶点分别与L2椎体、L2-3棘突间隙、L3椎体、L3-4棘突间隙和L4椎体相交的情况有4例、7例、53例、20例和16例。未检测到PSIS线相交的椎体水平与身高、体重和孕周参数之间存在显著相关性。
PSIS线通常与S1椎体相交，在孕妇中基于PSIS线的顶点相交的椎体水平范围为L2至L4椎体。基于PSIS线的三角形有辅助识别椎体水平的潜力，可应用于神经轴麻醉。
该研究在中国临床试验注册中心注册（注册号：ChiCTR-DDD-16010067）。
