Accuracy of Identifying the Intralaminar Space Clinical Trial
Official title:
Identification of the Lumbar Interspinous Spaces; Palpation Versus Ultrasound Versus Fluoroscopy
The of epidurals and spinals, relies primarily on palpation of anatomic landmarks that are
not always easy to find, More so, even after correct identification of palpable landmarks,
Variability exists leading to performing neuraxial injection in undetermined intralaminar
level. The most accurate method for identifying the interspace is the using of the
fluoroscopy or CT technique, but exposure to radiation and availability make it unpractical
in majority of cases. As ultrasound technology becomes more accessible to the clinician, it
holds great potential to facilitate performing neuraxial anesthesia by the anesthesiologist
in routine cases.
The aim of this study to compare the accuracy of identifying the intervertebral space,
between manual palpation, versus ultrasound versus fluoroscopy.
Neuraxial anesthesia relies upon a sound knowledge of anatomy to accurately direct needle
placement both to achieve consistent success, and to avoid damage to other nearby
structures. This prospective randomized study, will be performed in the pain management
unit. We will assess patients who are scheduled to receive an epidural steroid injection.
The investigator will request permission fro the ethics committee of Hadassah Medical
Hospital.
Three anesthesiologist will perform this study, every one of the anesthesiologist will be
asked to identify intralaminar space by one technique and we will compare the accuracy of
the identifying of the intralaminar space.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care