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Image-guided Access to the Spinal Subarachnoid Space in Children
Shah Islam1, Carmen Parra-Farinas2, Prakash Muthusami3
1Paediatric Interventional Neuroradiology, Department of Diagnostic & Interventional Radiology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; Department of Medical Imaging, University of Toronto, 263 McCaul Street, 4th Floor, Toronto, Ontario M5T 1W7, Canada. Electronic address: https://twitter.com/DrShahislam.
Image guidance for cerebrospinal fluid sampling in children improves success and safety. Ultrasound is preferred for infants, while fluoroscopy or cone beam CT suit older children with complex anatomy.
Area of Science:
- Pediatric Medicine
- Medical Imaging
- Neurosurgery
Background:
- Cerebrospinal fluid (CSF) sampling is a critical diagnostic procedure in pediatrics.
- Traditional methods carry risks of failure and complications.
- Image guidance is increasingly adopted to enhance procedural safety and efficacy.
Purpose of the Study:
- To review and discuss various image guidance techniques for pediatric CSF sampling.
- To highlight age-specific recommendations for imaging modalities.
- To inform clinicians on optimizing CSF collection procedures in children.
Main Methods:
- Review of current literature and clinical practices for pediatric CSF sampling.
- Discussion of imaging modalities including ultrasound, fluoroscopy, and cone beam CT.
- Analysis of technique suitability based on patient age and anatomical complexity.
Main Results:
- Ultrasound is the primary imaging guidance for neonates and infants.
- Fluoroscopy and cone beam CT are valuable for older children, especially with complex anatomy.
- Image guidance significantly improves success rates and reduces complications associated with CSF sampling.
Conclusions:
- Image-guided CSF sampling is the standard of care in pediatric patients.
- The choice of imaging modality should be tailored to the child's age and specific anatomical considerations.
- Implementing appropriate imaging guidance enhances patient outcomes and procedural efficiency.
