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Related Experiment Video

Updated: Jul 7, 2026

Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
07:30

Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery

Published on: May 4, 2022

Three-dimensional computed tomography for difficult thoracic epidural needle placement.

Hiroaki Murata1, Tetsuya Sakai, Shinichi Goto

  • 1Department of Anesthesiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki-City, Nagasaki 852-8501, Japan. hiroaki_muramura@yahoo.co.jp

Anesthesia and Analgesia
|January 30, 2008
PubMed
Summary

Difficult thoracic epidural needle placement can be predicted using preoperative 3D CT scans. Anatomical variations like occluded interlaminar spaces and ligament ossification correlate with placement challenges, aiding surgical planning.

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Last Updated: Jul 7, 2026

Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
07:30

Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery

Published on: May 4, 2022

Area of Science:

  • Anesthesiology
  • Radiology
  • Anatomy

Background:

  • Thoracic epidural anesthesia is crucial for postoperative pain management in thoracic surgery.
  • Difficulties in thoracic epidural needle placement arise from anatomical challenges, such as occluded interlaminar spaces.
  • Advancements in multi-detector row spiral computed tomography (CT) enable detailed 3D imaging of thoracic anatomy.

Purpose of the Study:

  • To investigate the correlation between challenging thoracic epidural needle placement and anatomical findings identified through 3D CT image processing.
  • To determine if 3D CT imaging can predict difficulties in thoracic epidural procedures.

Main Methods:

  • Seventy-eight patients undergoing thoracic procedures were studied.
  • Data collected included the number of skin puncture attempts and procedure time for successful epidural catheter insertion.
  • 3D CT images were analyzed for occluded mid-thoracic interlaminar spaces and ossification of supraspinous and interspinous ligaments.

Main Results:

  • The overall first-level success rate for needle placement was 84.6%.
  • Occluded mid-thoracic interlaminar spaces and ossification of the mid-thoracic supraspinous ligament were significantly more prevalent in cases of first-level failure (P < 0.001 and P = 0.001, respectively).
  • Increased needle attempts and procedure time strongly correlated with the number of occluded interlaminar spaces (P < 0.001).

Conclusions:

  • Preoperative 3D CT imaging shows promise in predicting difficult thoracic epidural needle placement.
  • Identifying anatomical variations preoperatively can help anesthesiologists anticipate and manage placement challenges.
  • This imaging technique can potentially improve procedural efficiency and patient outcomes.