Influence of lumbar spinous process deviation on spinal anesthesia puncture

So far, spinal anesthesia is still the main anesthesia method for lower extremity surgery. CT examination has been widely used in hospitals at all levels. Through pre-anesthesia CT examination, the deviation of lumbar spinous process and the difference between the apex of the spinous process and the pedicles on both sides are analyzed. The anatomical investigation of the included angle can better guide the angle and approach of spinal anesthesia puncture, and can better guide the anesthesia operation. For patients who need lower extremity surgery, preoperative lumbar spine CT scan is performed. The tangent line EF and the spinous process at the upper edge of L4 were measured, the tangent line EF was made at the posterior edge of the lumbar vertebrae, and the tangent line OG perpendicular to the line (the point O was the extension line of the lumbar spinous process and the line perpendicular to the tangent line EF were located at the posterior edge of the spinal canal). Intersection), measure the angle between the axis of the spinous process and the OG (∠AOG); measure the angle between the highest point of the spinous process (point A) and the pedicles on both sides (∠EAF); randomly divided into the experimental group (group A) and The control group (group B) was divided into two groups. In group A, puncture anesthesia was performed with the measured average of the deviated angle of the lumbar spinous process at the lower edge of L3 and the upper edge of L4. The puncture anesthesia and anesthesia operation were all performed by the same attending physician. Results: The lumbar spinous process has a certain degree of skewness in the normal population. The success rate of lumbar anesthesia puncture and the reduction of the incidence of nerve injury. Conclusion: The deviated lumbar spinous process has a certain influence on the lumbar anesthesia puncture using the method of positioning the surface of the spinous process space. Taking the angle between the apex of the spinous process and the pedicles on both sides as the adjustable angle range of the puncture needle can reduce the puncture injury and improve the safety and effect of anesthesia puncture.

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