Ultrasound versus palpation method for accurate estimation of intervertebral space: A cross-sectional observational study

Background and Aims: Spinal cord injury resulting from the central neuraxial blockade is a rare but dreadful complication. The most likely cause is believed to be misjudged level of the intervertebral space (IVS). In our study, we assessed the accuracy of IVS marked by the anesthesiologist in 170 patients who were posted for surgery under spinal anesthesia using ultrasonography. Methodology: This was a prospective examiner-blinded observational study in 170 patients. An anesthesiologist estimated and marked the IVS using conventional palpation method (based on intercristal line), and the level was counterchecked ultrasonically by another anesthesiologist, who was blinded to the initial marked level. Statistical Analysis: The agreement between the palpation method and ultrasound assessment of IVS was analyzed using the Chi-square test. P < 0.05 was considered statistically significant. Results and Conclusion: The IVS estimated by conventional palpation method correlated with ultrasound estimation in only 49.4% of patients.