Related Experiment Video
Updated: Jun 1, 2026
03:14
Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
Published on: January 31, 2025
Palpatory accuracy of lumbar spinous processes using multiple bony landmarks
Karen T Snider1, Eric J Snider, Brian F Degenhardt
1Osteopathic Manipulative Medicine, A.T. Still University/Kirksville College of Osteopathic Medicine, A.T. Still Research Institute, Kirksville, MO, USA. ksnider@atsu.edu
Summary
Accurate lumbar spinous process identification by palpation is possible but influenced by examiner experience and patient anatomy. This study found 69% accuracy, highlighting factors affecting precision in clinical settings.
Area of Science:
- Anatomy
- Clinical Procedures
- Medical Imaging
Background:
- Accurate localization of vertebral segments is critical for effective medical treatments.
- Palpation is a common method for identifying lumbar spinous processes.
Purpose of the Study:
- To evaluate the accuracy of identifying lumbar spinous process levels (L1-L4) through palpation.
- To assess factors influencing palpation accuracy, including examiner experience and anatomical variations.
Main Methods:
- Three examiners palpated L1-L4 spinous processes on 60 volunteers using multiple bony landmarks.
- Radiographs confirmed marker placement accuracy and identified anatomical anomalies.
- Weighted kappa values assessed accuracy and interobserver reliability.
Main Results:
- Overall correct identification of lumbar spinous process levels was 69% (κ = 0.81).
- Faculty examiners (78%) were more accurate than residents (51%).
- Anomalies (12th rib), obesity, and sex impacted accuracy.
Conclusions:
- Palpation accuracy for lumbar spinous processes is higher than previously reported but variable.
- Examiner experience, anatomical anomalies, and participant characteristics significantly affect accuracy.
Related Concept Videos
01:23Assessment of the Abdomen III: Palpation
Palpation is a crucial tactile examination method for assessing abdominal organs and detecting conditions like tenderness, distention, masses, or fluid. It involves both light and deep palpation techniques, each serving specific diagnostic purposes. Light palpation helps identify tenderness and other surface-level indicators, while deep palpation locates and assess abdominal masses and organ boundaries. A skilled professional can gather valuable insights through palpation, including evaluating...
01:30General Structure of a Vertebra
A typical vertebra, with the exception of the sacrum and coccyx, consists of a body, a vertebral arch, and seven different projections termed processes. The anterior portion of the vertebrae, the body, supports about half the body’s weight. The vertebral bodies progressively increase in size and thickness from the cervical region to the lumbar region of the vertebral column. The intervertebral discs present between the bodies of adjacent vertebrae firmly unites them, forming a continuous column.