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Ultrasound identification of landmarks preceding lumbar puncture: a pilot study
  1. R M Ferre1,
  2. T W Sweeney2,
  3. T D Strout2
  1. 1
    Wilford Hall Medical Center, Lackland AFB, Texas, USA
  2. 2
    Clinical Faculty, Department of Emergency Medicine, Maine Medical Center, Portland, Maine, USA
  1. Ms T D Strout, Department of Emergency Medicine, Maine Medical Center, 321 Brackett Street, Portland, ME 04102, USA; Strout{at}


Aim: To assess the utility of bedside ultrasound performed by an emergency physician in adults undergoing diagnostic lumbar puncture.

Method: Ultrasound was used as the primary means of determining the site of skin puncture, angle of needle advancement and depth needed to access the subarachnoid space.

Results: Cerebrospinal fluid was obtained from 36 of 39 patients (92.3%) in the first interspinous space attempted.

Conclusions: The ultrasonographically measured depth of the dura mater correlates strongly with the final needle depth.

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  • Additional figures are published online only at

  • Funding: None.

  • Competing interests: None.

  • Ethics approval: The study was approved by the Maine Medical Center IRB.

  • RMF, TWS and TDS conceived the study, designed the trial and conducted the trial and data collection. RMF and TWS both participated in subject identification and enrolment. RMF and TDS conducted subject follow-up, data analysis and interpretation and drafted the manuscript. All authors contributed substantially to its revision. RMF takes responsibility for the paper as a whole.