A guide to the landmarkguided paraspinous / paramedian approach to lumbar puncture, spinal, or epidural anesthesia. This is very useful in patients with narrowed midline interspinous spaces.
The repetition is intentional as always feel free to skip to the bits you like best! Also see links to relevant USguided neuraxial blocks in difficult patients
0:56 = Video of paraspinous approach in sitting position
2:52 = Stepbystep walkthrough
5:51 = Lateral decubitus position
7:08 = Video of paraspinous approach in lateral position
9:25 = Final tips
10:22 = Anatomy of spinous processes
12:55 = Obesity
14:04 = Scoliosis

US imaging of the spine in scoliosis    • Ultrasound Imaging for Neuraxial Bloc...  
US imaging of the spine in obesity    • Ultrasound Imaging in Obesity for Epi...