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Table 1 Needle entry point determination based on patient stratification using anatomical features offered by ultrasound and illustrated by CT scans

From: Evaluation of a modified ultrasound-assisted technique for mid-thoracic epidural placement: a prospective observational study

Category

AC visible

Explanation via CT

Needle entry point

PMSO

TM

Lateral offset

Caudal shift

I

Yes

Yes

Skinny-base SP with wide IS;

partially overlapping adjacent laminae

0.5 cm

1 cm

II

Yes

No

Slanted wide-base SP covering part of IS;

partially overlapping adjacent laminae; lateral part of IS open

1 cm

1 cm:

depth of lamina<4 cm;

1.5 cm:

depth of lamina ≥ 4 cm

III

No

No

Steeply slanted wide-base SP obstructing IS;

IS obstructed by closely overlapping lamina

1 cm

1.5 cm

  1. Abbreviations: AC = anterior complex; CT = computed tomography; IS = interlaminar space; PMSO = paramedian sagittal oblique; SP = spinous process; TM = transverse median