• Line Dussourd, Batistin Martinon, Clara Candille, Carole Paquier, Claire Wintenberger, Perrine Dumanoir, Anais Plazanet, Damien Viglino, and Maxime Maignan.
• Emergency Department, CHU Grenoble Alpes, CS 10217, 38043, Grenoble, cedex 9, France.
• Scand J Trauma Resus. 2017 Jun 27; 25 (1): 60.

BackgroundUltrasonography - assisted lumbar puncture helps physicians identify traditional anatomical landmarks. However, it could help to overcome the anatomical dogmas and thus identify the best interspinous space under the medullary cone.MethodsTraditional anatomical landmarks were reported on a tracing paper in patients with an indication for lumbar puncture. Then, ultrasonography was used to locate the optimal interspinous level defined as the widest subarachnoid space located below the conus medullaris. Primary endpoint was the distance between traditional and ultrasound landmarks.ResultsFifty-seven patients were included. Seven emergency physicians practiced the procedure. The median absolute distance between traditional anatomical landmarks and ultrasound marking was 32 [interquartile (IQR) 27 - 37] mm. The inter-spinous space identified in the two procedures was different in 68% of the cases.ConclusionsUltrasound not only allows us to better identify anatomical structures before lumbar puncture, but it also allows us to choose a site of puncture different from recommendations.

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