None listed
Conditions
Brief summary
Aims • To quantitatively describe details of normal lumbar interspinous ligament and interlaminar foramen anatomy. • To define features that may influence needle access to the neuraxis. Hypotheses • The anterior lumbar interspinous ligament may be bilaminar with a gap corresponding to a midline gap between the opposing leaves of the ligamentum flavum. • An anterior midline gap in the lumbar interspinous ligament contains fat. • The lumbar interspinous ligament may have structural gaps not related to the ligamentum flavum. • The gaps may have a size equivalent to an epidural needle orifice. Objectives • Derive morphometric data of posterior lumbar structures of normal adult volunteers using high-definition magnetic resonance and ultrasound imaging. • Present quantitative description of normal posterior lumbar structures in a manner directly applicable to the midline passage of a needle into the neuraxis. Methods Recruit normal adult volunteers. Record demographic data then generate and record measurements pertaining to their lumbar spine using clinical examination, ultrasound scanning and high-definition magnetic resonance imaging. Generate descriptive statistical results, compare equivalent measurements derived from the different modalities, and describe in detail anatomical midline and adjacent features that may be sensed during needle passage to the neuraxis.
Interventions
Single measurement event estimated to take up to 90 minutes. The study researcher (a registered medical practitioner specialist anaesthetist) will make observations gained by clinical examination and ultrasound imaging. The aim is to gain morphometric description of features that may be traversed during needle access to the neuraxis.
Surface anatomical landmarks of the participant will be mapped before ultrasound examination of structures posterior to T12 - S1. The participant will be seated ere
Single measurement event estimated to take up to 90 minutes. The study researcher (a registered medical practitioner specialist anaesthetist) will make observations gained by clinical examination and ultrasound imaging. The aim is to gain morphometric description of features that may be traversed during needle access to the neuraxis. Surface anatomical landmarks of the participant will be mapped before ultrasound examination of structures posterior to T12 - S1. The participant will be seated erect then in a flexed position for this. The following MRI will take 45 minutes and will be in a supine but flexed hip position to assist flattening of the lumbar lordosis. There will be no use of needles or placement of epidurals.
Sponsors
Centre for Advanced Imaging
Eligibility
Sex/Gender
All
Age
18 Years to 20 Years
Healthy volunteers
Yes
Inclusion criteria
normal volunteer adults
Exclusion criteria
over 20 years of age, History of abnormal growth History of back abnormality History of back ache or back pain History of treatments to back including but not limited to chiropractic or deep tissue massage History of trauma to the back History of elite physical performance History of nutritional deficiency Claustrophobia Unable to tolerate a working MRI environment Allergy to ultrasound gel or skin marker pens Non- consent or withdrawal of consent Unsuitable for MRI as set out in the Centre for Advanced Imaging (CAI) standard “MRI investigation screening form” Pregnant
Outcome results
None listed