Ultrasound-Guided Spine Anesthesia: Feasibility Study of a Guidance System

• Published in: Ultrasound in medicine & biology Vol. 42; no. 12; pp. 3043 - 3049
• Main Authors: Seitel, Alexander, Sojoudi, Samira, Osborn, Jill, Rasoulian, Abtin, Nouranian, Saman, Lessoway, Victoria A, Rohling, Robert N, Abolmaesumi, Purang
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.12.2016
• Subjects: Aged; Anesthesia, Epidural - instrumentation; Anesthesia, Epidural - methods; Epidural needle insertions; Facet joint injections; Feasibility Studies; Female; Guidance; Humans; Imaging, Three-Dimensional - methods; Lumbar Vertebrae - diagnostic imaging; Male; Model-based registration; Radiology; Reproducibility of Results; Ultrasonography, Interventional - methods; Ultrasound; Guidance; Facet joint injections; Ultrasound; Model-based registration; Epidural needle insertions
• ISSN: 0301-5629; 1879-291X
• DOI: 10.1016/j.ultrasmedbio.2016.07.008

Abstract Spinal needle injections are guided by fluoroscopy or palpation, resulting in radiation exposure and/or multiple needle re-insertions. Consequently, guiding these procedures with live ultrasound has become more popular, but images are still challenging to interpret. We introduce a guidance system based on augmentation of ultrasound images with a patient-specific 3-D surface model of the lumbar spine. We assessed the feasibility of the system in a study on 12 patients. The system could accurately provide augmentations of the epidural space and the facet joint for all subjects. Following conventional, fluoroscopy-guided needle placement, augmentation accuracy was determined according to the electromagnetically tracked final position of the needle. In 9 of 12 cases, the accuracy was considered sufficient for successfully delivering anesthesia. The unsuccessful cases can be attributed to errors in the electromagnetic tracking reference, which can be avoided by a setup reducing the influence of the metal C-arm.