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Review
. 2020 Oct 30;15(4):397-408.
doi: 10.17085/apm.20065.

Ultrasonography for lumbar neuraxial block

Seokha Yoo  1 , Youngwon Kim  1 , Sun-Kyung Park  1 , Sang-Hwan Ji  1 , Jin-Tae Kim  1
Affiliations
Review

Ultrasonography for lumbar neuraxial block

Seokha Yoo et al. Anesth Pain Med (Seoul). .

Abstract

Ultrasonography can be useful to perform a lumbar neuraxial block. It aids in understanding the anatomy of the lumbar spine before the procedure. Pre-procedural ultrasound imaging provides information about the accurate intervertebral level for puncture, optimal needle insertion point, and depth of needle advancement for a successful neuraxial block. The key ultrasonographic views for lumbar neuraxial block include the transverse midline interlaminar and parasagittal oblique views. Ultrasonography can facilitate lumbar neuraxial block in difficult cases, such as the elderly, obese patients, and patients with anatomical abnormality of the lumbar spine. This review elucidates the basics of spinal ultrasonography for lumbar neuraxial block and the current evidence regarding ultrasound-guided neuraxial block in adults.

Keywords: Anesthesia, epidural; Anesthesia, spinal; Lumbar vertebrae; Ultrasonography.

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Conflict of interest statement

CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Lumbar vertebrae anatomy.
Fig. 2.
Fig. 2.
Sagittal views of the lumbar spine. (A) Sagittal transverse process view, (B) sagittal articular process view, (C) sagittal lamina view, (D) sagittal spinous process view, (E) parasagittal oblique view. TP: transverse process, AP: articular process, L: lamina, SP: spinous process, PC: posterior complex, AC: anterior complex, SC: spinal canal (intrathecal space).
Fig. 3.
Fig. 3.
Transverse views of the lumbar spine. (A) Transverse spinous process view, (B) transverse interspinous process view, (C) tilted transverse interspinous process view. SP: spinous process, AP: articular process, L: lamina, PC: posterior complex, AC: anterior complex, SC: spinal canal (intrathecal space).
Fig. 4.
Fig. 4.
Diagonal view of the lumbar spine. Probe is applied over the spinous process of the upper lumbar vertebra and lamina of the lower lumbar vertebra. SP: Spinous process, SC: spinal canal, L: lamina. Arrow: pathway of spinal needle.
Fig. 5.
Fig. 5.
Ultrasound scans for patients with scoliosis. (A) Paramedian approach. (B) Midline approach.
See this image and copyright information in PMC

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