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...

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Main Author:	Chia Sing, Wong
Format:	Thesis
Language:	English
Published:	2015
Subjects:	RC Internal medicine
Online Access:	http://eprints.usm.my/41102/1/Dr._Wong_Chia_Sing-24_pages.pdf
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spelling	my-usm-ep.411022019-04-12T05:25:54Z The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation 2015 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 http://eprints.usm.my/41102/ http://eprints.usm.my/41102/1/Dr._Wong_Chia_Sing-24_pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RC Internal medicine
spellingShingle	RC Internal medicine Chia Sing, Wong The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation
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
format	Thesis
qualification_level	Master's degree
author	Chia Sing, Wong
author_facet	Chia Sing, Wong
author_sort	Chia Sing, Wong
title	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_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_sort	accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2015
url	http://eprints.usm.my/41102/1/Dr._Wong_Chia_Sing-24_pages.pdf
_version_	1747820875336384512

The accuracy of ultrasound guided technique for lumbar intervertebral disc level localisation

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