Chia Sing, Wong
(2015)
The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction and objective
Spinal level localisation is a very important factor in any spine surgery to ensure
that the operation is performed at the correct site. C-arm image intensifier is the current
practice in operating theatre for most of the spinal surgery. However, its use is related
to a few problems. Ultrasound can be a good alternative. Ultrasound guided technique
has gain popularity for spinal procedure especially among anaesthetist and
rheumatologist.
Study design and methodology
This was a cross-sectional study of 80 participant equally divided into normal
spine group and degenerative spine group. Ultrasound guided intervertebral disc
localisation of L3/L4, L4/L5 and L5/S1 was performed on all participant in prone
position by a single operator. A standardised steps were used and inferior edge of
spinolaminar junction of the overlying vertebral was used as a sonographic landmark
representing a particular disc level. A radiopaque marker was placed on each disc level
identified for accuracy checking using X-ray machine or C-arm image intensifier.
Radiopaque marker crossing at least 50% of the width of the intended intervertebral disc
was defined as accurate.
Result
Pertinent landmark for intervertebral disc localisation were identified with
ultrasound guidance in all participants with overall accuracy rate of 65.0%. No
significant different in accuracy localising L3/L4 disc in normal spine (32.5%) and
degenerative spine (40.0%) group. However accuracy was significantly higher in
normal group (82.5%) compared to degenerative group (60.0%) at L4/L5 disc level. We
had higher accuracy localising L5/S1 disc in both groups with same accuracy of 87.5%.
Conclusion
Ultrasound guidance intervertebral disc localisation is a feasible approach to
localise lumbar discs using spinolaminar junction of overlying vertebra as a landmark.
It can be safely performed at L5/S1 disc level in patient with or without degenerative
spine disease. It can also be considered in patients without degenerative spine disease at
L4/L5 disc level. However it is not recommended to localise L3/L4 disc level.
Keywords : Lumbar, intervertebral disc, disc level localisation, ultrasound,
sonoanatomy
Actions (login required)
 |
View Item |
![[img]](http://eprints.usm.my/style/images/fileicons/application_pdf.png)
