Research On Correlations Of The The Vertebral Level Across The Intercristal Line In Term Pregnancy In Yanbian Area

ObjectiveApply low-frequency ultrasonic technology to observe pregnant woman of Yanbian area,which the corresponding vertebral body level of the iliac crest line and the spine.To evaluate the accuracy of the intercrestal line as the marker of the L4 spinous process or L34 intervertebral space in pregnant women.To provide a clinical reference for the selection of spinal epidurai anesthesia puncture clearance in cesarean section.MethodsNinety term pregnant patients undergoing cesarean section with neuraxial block were enrolled.Among them,there are 42 cases of Korean nationality and 48 cases of han nationality.Aged between 20 to 40 years.Height between 145-170cm.BMI in the range of 18-45kg/m2.Exclude combine of obstetric and cardiovascular diseases.Have contraindication to intraspinal anesthesia.Pain scores>4 or unable to cooperate with positioning.All of these patients were placed in left lateral position with their hips and knees flexed.At the beginning,an anesthesiologist palpated the superior aspects of the iliac crest and draw a line,then mark the place which cross the vertebral column.This is considered to be the level of L3-4 intervertebral space or the L4 spinous processes.Then another doctor with rich experience of operation of ultrasound.Using portable instrument ultrasound to scan from the sacrum region to the cephalic side.According to the characteristics of the spine sonogram,identify each vertebral body and clearance in turn and determine the level of the vertebral which the first doctor marked.Then analysis the correlation of intercrestal line pass through the lumbar between age,body mass index and nationalityResultsAll 90 patients with the highest point of L2-3 and lowest point of L5.Among which,71.1%were located in the interstitial space of L3-4 interspinal interstice or at the level of L4 spinous process,that conforms to the palpation positioning by body surface signs,20%were located in the interstitial space of L2-3 interspinal interstice or at the level of L3 spinous process,9%were located in the interstitial space of L4-5 interspinal interstice or at the level of Ls spinous process.There was no statistically significant difference in the level of vertebral body between the Han nationality and the Korean nationality(P= 0.956);The position of vertebral have no significant difference in age,height and weight(P= 0.639?P= 0.367?P= 0.190),There was a BMI statistical difference between the six groups(P=0.027).As the BMI of patient increases,the position of the corresponding vertebral body is higher(r = 0.234,P = 0.027,r = 0.253,P =0.016).There is no related to age and height of vertebral level(r = 0.050,P = 0.639,r = 0.051,P=0.631).ConclusionThe level of spine acorss the intercrestal line is used as the body surface marker of the L3-4 interspinal interstice or L4 spinous process in term pregnant women,may lead to the wrong positioning.The level of the lumbar across the intercristal line was affected by weight and BMI,Have no related to height and age.Before the spinal anesthesia is performed,use low-frequency ultrasound can improve positioning accuracy and reducerelated anesthesia complications.