Quantitative anatomical analysis of lumbar interspaces based on 3D CT imaging : optimized segment selection for lumbar puncture in different age groups
© 2024. The Author(s)..
BACKGROUND: Optimal lumbar puncture segment selection remains controversial. This study aims to analyze anatomical differences among L3-4, L4-5, and L5-S1 segments across age groups and provide quantitative evidence for optimized selection.
METHODS: 80 cases of CT images were collected with patients aged 10-80 years old. Threedimensional models containing L3-S1 vertebrae, dural sac, and nerve roots were reconstructed. Computer simulation determined the optimal puncture angles for the L3-4, L4-5, and L5-S1 segments. The effective dural sac area (ALDS), traversing nerve root area (ATNR), and area of the lumbar inter-laminar space (ALILS) were measured. Puncture efficacy ratio (ALDS/ALILS) and nerve injury risk ratio (ATNR/ALILS) were calculated. Cases were divided into four groups: A (10-20 years), B (21-40 years), C (41-60 years), and D (61-80 years). Statistical analysis was performed using SPSS.
RESULTS: 1) ALDS was similar among segments; 2) ATNR was greatest at L5-S1; 3) ALILS was greatest at L5-S1; 4) Puncture efficacy ratio was highest at L3-4 and lowest at L5-S1; 5) Nerve injury risk was highest at L5-S1. In group D, L5-S1 ALDS was larger than L3-4 and L4-5. ALDS decreased after age 40. Age variations were minimal across parameters.
CONCLUSION: The comprehensive analysis demonstrated L3-4 as the optimal first-choice segment for ages 10-60 years, conferring maximal efficacy and safety. L5-S1 can serve as an alternative option for ages 61-80 years when upper interspaces narrow. This study provides quantitative imaging evidence supporting age-specific, optimized lumbar puncture segment selection.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:66 |
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| Enthalten in: |
Neuroradiology - 66(2024), 3 vom: 07. Feb., Seite 443-455 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhuang, Yuan-Dong [VerfasserIn] |
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| Links: |
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| Themen: |
3D modeling |
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| Anmerkungen: |
Date Completed 14.02.2024 Date Revised 14.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00234-023-03272-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 245 | 1 | 0 | |a Quantitative anatomical analysis of lumbar interspaces based on 3D CT imaging |b optimized segment selection for lumbar puncture in different age groups |
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| 520 | |a © 2024. The Author(s). | ||
| 520 | |a BACKGROUND: Optimal lumbar puncture segment selection remains controversial. This study aims to analyze anatomical differences among L3-4, L4-5, and L5-S1 segments across age groups and provide quantitative evidence for optimized selection | ||
| 520 | |a METHODS: 80 cases of CT images were collected with patients aged 10-80 years old. Threedimensional models containing L3-S1 vertebrae, dural sac, and nerve roots were reconstructed. Computer simulation determined the optimal puncture angles for the L3-4, L4-5, and L5-S1 segments. The effective dural sac area (ALDS), traversing nerve root area (ATNR), and area of the lumbar inter-laminar space (ALILS) were measured. Puncture efficacy ratio (ALDS/ALILS) and nerve injury risk ratio (ATNR/ALILS) were calculated. Cases were divided into four groups: A (10-20 years), B (21-40 years), C (41-60 years), and D (61-80 years). Statistical analysis was performed using SPSS | ||
| 520 | |a RESULTS: 1) ALDS was similar among segments; 2) ATNR was greatest at L5-S1; 3) ALILS was greatest at L5-S1; 4) Puncture efficacy ratio was highest at L3-4 and lowest at L5-S1; 5) Nerve injury risk was highest at L5-S1. In group D, L5-S1 ALDS was larger than L3-4 and L4-5. ALDS decreased after age 40. Age variations were minimal across parameters | ||
| 520 | |a CONCLUSION: The comprehensive analysis demonstrated L3-4 as the optimal first-choice segment for ages 10-60 years, conferring maximal efficacy and safety. L5-S1 can serve as an alternative option for ages 61-80 years when upper interspaces narrow. This study provides quantitative imaging evidence supporting age-specific, optimized lumbar puncture segment selection | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a 3D modeling | |
| 650 | 4 | |a Age factor | |
| 650 | 4 | |a Efficacy ratio | |
| 650 | 4 | |a Lumbar puncture | |
| 650 | 4 | |a Segment selection | |
| 700 | 1 | |a Hu, Xiao-Cong |e verfasserin |4 aut | |
| 700 | 1 | |a Dai, Ke-Xin |e verfasserin |4 aut | |
| 700 | 1 | |a Ye, Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Chen-Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Zhuo, Wen-Xuan |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Jian-Feng |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Shi-Chao |e verfasserin |4 aut | |
| 700 | 1 | |a Liang, Ze-Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Chun-Mei |e verfasserin |4 aut | |
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