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21KF-018
Correlation between needle depth for lumbar interlaminar epidural injection and body measurements of patients
Ji Yeon Kim1, Jae Hun Kim1
Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
Background
Interlaminar epidural injection (ILEI) is widely used to relieve low back pain with or without radiating pain which caused by irritated spinal nerves in medical practice.[1] The distance from skin to dorsal epidural space determines needle depth and it is influenced by the patient’s body measurement. This study investigated the correlation between the needle depth for ILEIs and patients’ body profiles such as weight, height, and BMI, with the aid of the patient\'s MRI scan.

Methods
This study was conducted retrospectively and reviewed 386 patients who underwent ILEIs in a single pain clinic center. In each case, the needle depth was measured on sagittal view of MRI scan. Besides the skin-to-epidural depth, the angle applied caudally was also measured. Needle depth and needle angle were measured for L3-L4, L4-L5, and L5-S1 ILEIs.

Results
A total 4632 measurements of 386 patients were reviewed. Linear regression analysis was done for variables of height, weight, height and weight combined, and BMI for three different levels. The coefficient of determination was significantly higher for the variables of height and weight combined, and BMI. Based on the analysis, following equations were established: Depth(mm) = a [BMI (kg/m2)] + b for the relationship between needle depth and a patient’s BMI, and Depth(mm) = c [Height(cm)] + d [Weight(kg)] + e for the relationship between needle depth and a patient’s height and weight.

Conclusion
Among information of a patient’s body measurement, both height and weight, as well as BMI may be helpful to estimate the optimal needle depth from skin to epidural space. Using the equations established in this study, more proper choice and preparation of the needle can be made. Furthermore, it will be useful for practitioners to lower the risk of unwanted puncture of dura mater during ILEIs and reduce associated discomforts for patients.