Dura-to-Spinal Cord Distance at Different Vertebral Levels in Indian Children: A Retrospective Computerized Tomography Scan-Based Study.

Anesthesia, Essays and Researches Pub Date : 2022-01-01 Epub Date: 2022-07-06 DOI:10.4103/aer.aer_26_22

Heena Garg, Shailendra Kumar, Naren Hemachandran, Prabudh Goel, Devasenathipathy Kandasamy, Minu Bajpai, Puneet Khanna

{"title":"Dura-to-Spinal Cord Distance at Different Vertebral Levels in Indian Children: A Retrospective Computerized Tomography Scan-Based Study.","authors":"Heena Garg, Shailendra Kumar, Naren Hemachandran, Prabudh Goel, Devasenathipathy Kandasamy, Minu Bajpai, Puneet Khanna","doi":"10.4103/aer.aer_26_22","DOIUrl":null,"url":null,"abstract":"Background: Neuraxial techniques provide good postoperative analgesia for painful procedures in the pediatric population. However, any injury to the spinal cord can lead to irreversible long-term effects.Aims: We aimed to evaluate dura-to-cord (DTC) distance from computerized tomography (CT) images of thoracolumbar spine in pediatric age group (1-16 years) at T8-9, T9-10, and L1-2 interspaces to identify the safe space for epidural insertion in Asian children.Settings and design: It was a retrospective study including 141 children aged 1-16 years who underwent routine CT scan of the thoracolumbar region for unrelated diagnostic indications.Materials and methods: Patients with spinal abnormalities were excluded. Sagittal CT images of the thoracolumbar spine were obtained to calculate the DTC at T8-9, T9-10, and L1-2 interspaces. The measurements at all levels were obtained perpendicular to the long axis of the vertebral body.Statistical analysis used: Continuous data were depicted as mean with standard deviations. The categorical data were presented as counts with percentages.Results: The mean DTC distance at T8-9, T9-10, and L1-2 interspaces was 3.51 ± 0.98 mm (95% confidence interval [CI]: 3.35-3.67), 2.73 ± 0.94 mm (95% CI: 2.57-2.89), and 2.83 ± 1.08 mm (95% CI: 2.66-3.02), respectively. A significant difference was found between the genders at T9-10 (P = 0.02) and L1-2 levels (P = 0.04). No difference in DTC was found in toddlers, preschool children, school-going children, and adolescents. DTC at T8-9 showed a significant correlation with age (R 2 = 0.0479; P = 0.04), weight (R 2 = 0.038; P = 0.02), and height (R 2 = 0.037; P = 0.03).Conclusion: Thoracic epidural space can be used in children and adolescents for epidural catheter placement. T8-9 level showed maximum DTC distance and significant correlation with age, height, and weight in CT imaging in the present study.","PeriodicalId":7798,"journal":{"name":"Anesthesia, Essays and Researches","volume":"16 1","pages":"138-142"},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9558667/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anesthesia, Essays and Researches","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/aer.aer_26_22","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/7/6 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Neuraxial techniques provide good postoperative analgesia for painful procedures in the pediatric population. However, any injury to the spinal cord can lead to irreversible long-term effects.

Aims: We aimed to evaluate dura-to-cord (DTC) distance from computerized tomography (CT) images of thoracolumbar spine in pediatric age group (1-16 years) at T_8-9, T_9-10, and L_1-2 interspaces to identify the safe space for epidural insertion in Asian children.

Settings and design: It was a retrospective study including 141 children aged 1-16 years who underwent routine CT scan of the thoracolumbar region for unrelated diagnostic indications.

Materials and methods: Patients with spinal abnormalities were excluded. Sagittal CT images of the thoracolumbar spine were obtained to calculate the DTC at T_8-9, T_9-10, and L_1-2 interspaces. The measurements at all levels were obtained perpendicular to the long axis of the vertebral body.

Statistical analysis used: Continuous data were depicted as mean with standard deviations. The categorical data were presented as counts with percentages.

Results: The mean DTC distance at T_8-9, T_9-10, and L_1-2 interspaces was 3.51 ± 0.98 mm (95% confidence interval [CI]: 3.35-3.67), 2.73 ± 0.94 mm (95% CI: 2.57-2.89), and 2.83 ± 1.08 mm (95% CI: 2.66-3.02), respectively. A significant difference was found between the genders at T_9-10 (P = 0.02) and L_1-2 levels (P = 0.04). No difference in DTC was found in toddlers, preschool children, school-going children, and adolescents. DTC at T_8-9 showed a significant correlation with age (R ² = 0.0479; P = 0.04), weight (R ² = 0.038; P = 0.02), and height (R ² = 0.037; P = 0.03).

Conclusion: Thoracic epidural space can be used in children and adolescents for epidural catheter placement. T_8-9 level showed maximum DTC distance and significant correlation with age, height, and weight in CT imaging in the present study.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

印度儿童不同椎体水平的硬脑膜到脊髓距离:一项基于计算机断层扫描的回顾性研究。

背景:轴向技术为儿童疼痛手术提供了良好的术后镇痛。然而，脊髓的任何损伤都可能导致不可逆转的长期影响。目的:我们旨在评估儿童年龄组(1-16岁)胸腰椎T8-9、T9-10和L1-2间隙的硬脊膜到脊髓(DTC)距离，以确定亚洲儿童硬膜外插入的安全空间。背景和设计:这是一项回顾性研究，包括141名年龄在1-16岁的儿童，他们接受了常规的胸腰椎CT扫描，以寻找不相关的诊断指征。材料与方法:排除脊柱异常患者。获取胸腰椎矢状位CT图像，计算T8-9、T9-10和L1-2间隙处的DTC。所有水平的测量都垂直于椎体的长轴。采用统计分析:连续数据用平均值和标准差表示。分类数据以计数和百分比表示。结果:T8-9、T9-10和L1-2间隙的平均DTC距离分别为3.51±0.98 mm(95%可信区间[CI]: 3.35 ~ 3.67)、2.73±0.94 mm (95% CI: 2.57 ~ 2.89)和2.83±1.08 mm (95% CI: 2.66 ~ 3.02)。T9-10和L1-2水平的性别差异有统计学意义(P = 0.04)。幼儿、学龄前儿童、学龄儿童和青少年的DTC没有差异。t8 ~ 9时DTC与年龄有显著相关(r2 = 0.0479;P = 0.04)，权重(r2 = 0.038;P = 0.02)、身高(r2 = 0.037;P = 0.03)。结论:胸椎硬膜外腔可用于儿童和青少年硬膜外置管。在本研究中，T8-9水平的DTC距离最大，与年龄、身高、体重有显著相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Anesthesia, Essays and Researches

自引率

0.00%

发文量