The Level of Tuffier's Line of Korean Adults in the Lateral Decubitus Position with the Position of "Forehead-to-knees".
10.4097/kjae.1998.35.4.691
- Author:
Il Ok LEE
1
;
Jae Hwan KIM
;
Young Cheol PARK
;
Jung Yul PARK
;
Sang Hoon CHA
Author Information
1. Department of Anesthesiology, Korea University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Anatomy: spine;
Tuffier's line;
Position: lateral;
forehead-to-knees
- MeSH:
Adult*;
Aging;
Anesthesia, Epidural;
Back Pain;
Female;
Humans;
Male;
Spinal Puncture;
Spine;
Supine Position
- From:Korean Journal of Anesthesiology
1998;35(4):691-695
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGREOUND: Tuffier's line has been a guide for lumbar puncture. Usually lumbar puncture or epidural anesthesia was performed in the lateral decubitus position with the "forehead-to-knees" position. The purpose of this study was to identify the accuracy with which the spinal level could be predicted from this external mark in the "forehead-to-knees" position. METHODS: Two hundred and twenty-four patients (112 male and 112 female patients) undergoing investigation for back pain were examined. The standard antero-posterior lumbar spine film was taken in the supine position. The lateral lumbar spine film was taken in the lateral decubitus with the "forehead-to-knees" position. These films were examined after being reported upon by a radiologist. The iliac crest was identified and a horizontal line drawn between the highest points using a ruler. The level of Tuffier's line of each age group in supine or "forehead-to-knees" position and relationship with aging were observed. RESULTS: The point coincided with the L4-5 interspace (61%), L4 (20%), and L5 (19%) in the supine, L4-5 (48%), L5 (46%), L4 (5%), and L5S1 (0.4%) in the "forehead-to-knees" position. The Tuffier's line of men were higher than women. The Tuffier's line in the "forehead-to-knees" position went higher with aging in women. CONCLUSIONS: The Tuffier's line was most frequently the L4-5 interspace in supine and "forehead-to-knees" positions. The Tuffier's line in the "forehead-to-knees" was lower than the supine position. The Tuffier's line of men were higher than women of all age groups in the supine position. The Tuffier's line in the "forehead-to-knees" position went higher with aging in women. The Tuffier's line in the supine position in women and of both positions in men did not show any relation with age.
