Soonchunhyang Med Sci.  2012 Jun;18(1):9-11.

Is the Spinous Process of T7 Usually at the Same Level as the Inferior Tips of the Scapulae?

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea. syok2377@naver.com
  • 2Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of General Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.

Abstract


OBJECTIVE
Appropriate placement of thoracic epidural catheter provides an adequate postoperative analgesia in chest and upper abdominal surgery. Usually, when thoracic epidural puncture is performed, both scapular lower tips and the thoracic (T)7 spinous process is assumed to be at the same horizontal level. The aim of this study is to identify the thoracic epidural puncture in the sitting position, with the neck flexed and arms crossed, may change the relationship between the thoracic vertebrae and the scapular lower tips.
METHODS
One hundred patients with postoperative patient controlled epidural analgesia using thoracic epidural catheters were enrolled. It is presumed that the both scapular lower tips and T7 spinous process is at the equal level when performing thoracic epidural puncture. The actual insertion level of the Tuohy needle was examined by radiography when the patient was in the sitting position.
RESULTS
Out of 100 patients, there were 62% that were in the same level as the scapular lower tips and T7 spinous process. However, 1% of the patients leveled at T4, 1% at T5, 25% at T6, 18% at T8, and 1% at T9.
CONCLUSION
When performing the thoracic epidural puncture under the sitting position, the relationship of the T7 and the scapular lower tips may change. The change of position of scapular lower tips varied among T6.82+/-0.70. Therefore, to be precise, it is advised to utilize C-arm guide when epidural puncture is carried out.

Keyword

Scapular lower tips; Seventh cervical spinous process; Seventh thoracic spinous process; Surface anatomy landmark; Thoracic epidural puncture

MeSH Terms

Analgesia
Analgesia, Epidural
Arm
Catheters
Humans
Neck
Needles
Punctures
Thoracic Vertebrae
Thorax
Full Text Links
  • SMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr