体位对老年患者腰椎间隙黄韧带长度超声测值的影响.

Objective To investigate effect of body position on ultrasonographic measurement of ligamentum flavum length in lumbar intervertebral space in the elderly patients. Methods 40 patients over 65 years of age who underwent spinal anesthesia were selected to examine the L3/4, L4/5 and L5 / S1 intervertebral spaces. Anterioredge length of the ligamentum flavum (ALL) and distance from skin to the ligamentum flavum (DSL) of L3/4, L4/5 and L5/S1 intervertebral spaces were measured by ultrasonic parasagittal oblique view in both sitting and left lateral decubitus position, and definition degree of each ultrasonic image were analyzed. Results Compared with the measurement in left lateral position, ALL at L5/S1 level in sitting position was longer, and longer than that at L3/4 in the same position (P < 0.05)；DSL at L5/S1 was lower than that at L3/4 in sitting position (P < 0.05). Compared with ultrasonic definition of L5/S1, the fine definition rate of the left and right sides of L3/4 and L4/5 in both positions was lower (P < 0.05). Conclusion The ALL ultrasonic measurement at L5/S1 level in sitting position was longer than that in left lateral decubitus position, and also longer than that at L3/4 and L4/5 in the same position, its depth and image were shallower and clearer than other spaces. It is recommended for elderly patients to use the paramidian puncture approach for lumbar anesthesia. The relatively shallow width of L5/ S1 should be selected under the sitting position, and the left and right sides are equivalent, especially under the guidance of ultrasound. [ABSTRACT FROM AUTHOR]