The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation
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...
| Main Author: | |
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| Format: | Thesis |
| Language: | English |
| Published: |
2015
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| Subjects: | |
| Online Access: | http://eprints.usm.my/41102/1/Dr._Wong_Chia_Sing-24_pages.pdf |
| _version_ | 1797010568075280384 |
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| author | Chia Sing, Wong |
| author_facet | Chia Sing, Wong |
| author_sort | Chia Sing, Wong |
| collection | USM |
| description | 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
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| first_indexed | 2024-03-06T15:21:41Z |
| format | Thesis |
| id | usm.eprints-41102 |
| institution | Universiti Sains Malaysia |
| language | English |
| last_indexed | 2024-03-06T15:21:41Z |
| publishDate | 2015 |
| record_format | dspace |
| spelling | usm.eprints-411022019-04-12T05:25:54Z http://eprints.usm.my/41102/ The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation Chia Sing, Wong RC Internal medicine 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 2015 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/41102/1/Dr._Wong_Chia_Sing-24_pages.pdf Chia Sing, Wong (2015) The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation. Masters thesis, Universiti Sains Malaysia. |
| spellingShingle | RC Internal medicine Chia Sing, Wong The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation |
| title | The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation |
| title_full | The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation |
| title_fullStr | The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation |
| title_full_unstemmed | The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation |
| title_short | The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation |
| title_sort | accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation |
| topic | RC Internal medicine |
| url | http://eprints.usm.my/41102/1/Dr._Wong_Chia_Sing-24_pages.pdf |
| work_keys_str_mv | AT chiasingwong theaccuracyofultrasoundguidedtechniqueforlumbarintervertebraldisclevellocalisation AT chiasingwong accuracyofultrasoundguidedtechniqueforlumbarintervertebraldisclevellocalisation |