Published in:
01-02-2018 | Correspondence
A method for improving access to the paramedian epidural space in the lumbar region
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 2/2018
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To the Editor,
Figure
Position 4 is illustrated with a subject positioned in lumbar flexion, with dorsal table-tilt and shoulders rotated to the right. The inset shows the effects on the L3/L4 vertebrae with the grey shadow depicting the original position of the vertebrae in the neutral position. Lumbar spinal flexion moves the spinous processes apart, and right shoulder rotation enlarges the interlaminar space by moving the L3 spinous process away from the L4 lamina. Thus, lumbar spinal flexion and right shoulder rotation theoretically increase the target area for needle placement during epidural or spinal anesthesia
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