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31 Mar 2024 (Vol 47 , Iss 03 )

Journal ID : TMJ-31-01-2022-11066
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Title : Refined radio-anatomical lumber level of iliac crest attic

Abstract :

Many surgical, anesthetic, and clinical procedures are identified by the correlation between the iliac crest level in comparison to the lumbar vertebrae, this is in one hand while on the other hand, many procedures found the iliac crest comes in the way of the surgeon or the anesthetist and hence the importance of the exact radiological determination of the iliac crest level. The measurements were taken for 56 patients who underwent surgical or anesthetic procedures. They were divided into 29 (52%) females and 27(48%) males, to whom pure lateral XR was taken in lying position to simulate their position later on over the operative table, The L4, L5, and intervertebral disc in-between them was divided into the following zonal areas: L4 upper zone, L4 middle zone, L4 lower zone, L4-5 disc zone, L5 upper zone, L5 middle zone, and L5 lower zone. A pure lateral radiograph was intended so that bias that may happen due to tilting of the body was avoided. Whenever there was mismatching between the right and left iliac crests on the XR ray film, the difference between the two was taken and the mean of the two levels was used. The top of the iliac crest was recorded according to its level in comparison to the previously mentioned zones. The patient’s age, sex, weight, and height were recorded, and the body mass index (BMI) was calculated for each. Iliac crest level according to the lumbar vertebral zones, the highest percentage of males found at L4-5 intervertebral disc 66.7% of the 26.8% of the cases while the highest percentage of females was found at L5 upper zone 66.7% of the 42.7% of the total cases. There was no statistically significant correlation between the patient’s sex, age, weight, height, and BMI with the iliac crest lumbar level. Radiological identification of the iliac crest level is crucial before performing any clinical surgical or anesthetic procedure, since the exact entry point of many probes, canulae or scopes may be determined by that from one point of view, while in the second hand we found that the iliac crest itself may come in the way of the surgeon or the anesthesiologist during performing the medical procedure. So knowing the exact level is important, in addition to the fact that radiological determination of the level is not like the palpation method in being more accurate and less likely to be affected by the patient’s sex, age, weight, height, and body mass index.

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