ULTRASOUND MEASUREMENT OF THE VERTEBRAL LEVEL OF TUFFIERS LINE IN ELDERLY WOMEN (A COMPARITIVE CROSS SECTIONAL STUDY)

Background:Sometimes , generalizing the vertebral level which is determined by palpation in patients across all the age groups may be inaccurate. This study has aimed to compare the vertebral level intersected by the Tuffiers line in elderly women versus adult womenutilizing an ultrasound in the left lateral decubitus flexed position, to provide a more precise understanding of the potential age-related differences .

Methods:We enrolled 50 female patients over the age of 65 (elderly group) and 50 female patients between ages 20-50 (control group) who had been scheduled to undergo surgeries under spinal Anaesthesia. Using ultrasound, we marked the L2–L5 lumbar spinous processes and intervertebral spaces. The most cephalad part was labeled as 1 and the most caudal part was labeled 11. We then identified to which line of these vertebral levels Tuffiers line crossed using an ultrasound.

Results:In the elderly group, the median vertebral level of Tuffiers line was found to be located at L2-L3 (median value = 3), whereas in the control group, it was situated at the lower part of L4 (median value = 8). Moreover, asignificant correlation was found between the vertebral level of Tuffiers line and age, weight and BMI in the elderly group (P < 0.001), indicating a significant association between these factors.

Conclusions:The ultrasound measurement in the left lateral decubitus flexed position revealed that the Tuffiers line was situated more cranially (towards the head) in elderly women compared to the control group. This indicates that the needle may inserted at a higher level than anticipated, indicating the importance of careful level determination during spinal Anaesthesia in elderly women to avoidcomplications.