Position-related variability of CSF opening pressure measurements

K. M. Schwartz, Patrick H Luetmer, Christopher Hunt, A. L. Kotsenas, F. E. Diehn, L. J. Eckel, David Black, Vance T Lehman, E. P. Lindell

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: Normative data for CSF OP have previously been established with patients in the LD position. During fluoroscopically guided LP procedures, radiologists frequently obtain these OP measurements with patients prone. In this prospective study, our goal was to determine the variability of OP measurements as a function of patient positioning and to assess whether there is a relationship with patient BMI. MATERIALS AND METHODS: Consecutive patients reporting for fluoroscopically guided LP or myelography were enrolled. OP was measured with the patient in 3 positions, with the order of the technique randomized: prone with table flat, prone with table tilted until the hub of the needle was at the level of the right atrium, and LD with the needle hub at the level of the spinal canal. The BMI of each patient was calculated. The Wilcoxon signed-rank test and linear regression analysis with bivariate fit of difference were used for analysis. RESULTS: OP measurements with the patient in the prone position were significantly elevated compared with those in the LD position, with mean differences of 2.7 (P < .001) and 1.6 cm H2O, (P = .017) for prone flat and prone tilted, respectively. There was no significant difference in OP measurements for the prone flat versus prone tilted positions (P = .20). There was no correlation between BMI and observed differences (LD-flat: R2 = 0.00028; LD-tilt: R2 = 0.00038; prone-tilt: R2 = 0.00000020). CONCLUSIONS: Measuring OP with the patient in the prone position may result in overestimation of CSF pressure. Table tilt did not significantly impact mean prone OP. Radiologists should specify exact patient positioning when reporting OP measurements.

Original languageEnglish (US)
Pages (from-to)904-907
Number of pages4
JournalAmerican Journal of Neuroradiology
Volume34
Issue number4
DOIs
StatePublished - Apr 2013

Fingerprint

Pressure
Prone Position
Patient Positioning
Needles
Myelography
Spinal Canal
Nonparametric Statistics
Heart Atria
Linear Models
Regression Analysis
Prospective Studies
Radiologists

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

Cite this

Schwartz, K. M., Luetmer, P. H., Hunt, C., Kotsenas, A. L., Diehn, F. E., Eckel, L. J., ... Lindell, E. P. (2013). Position-related variability of CSF opening pressure measurements. American Journal of Neuroradiology, 34(4), 904-907. https://doi.org/10.3174/ajnr.A3313

Position-related variability of CSF opening pressure measurements. / Schwartz, K. M.; Luetmer, Patrick H; Hunt, Christopher; Kotsenas, A. L.; Diehn, F. E.; Eckel, L. J.; Black, David; Lehman, Vance T; Lindell, E. P.

In: American Journal of Neuroradiology, Vol. 34, No. 4, 04.2013, p. 904-907.

Research output: Contribution to journalArticle

Schwartz, KM, Luetmer, PH, Hunt, C, Kotsenas, AL, Diehn, FE, Eckel, LJ, Black, D, Lehman, VT & Lindell, EP 2013, 'Position-related variability of CSF opening pressure measurements', American Journal of Neuroradiology, vol. 34, no. 4, pp. 904-907. https://doi.org/10.3174/ajnr.A3313
Schwartz, K. M. ; Luetmer, Patrick H ; Hunt, Christopher ; Kotsenas, A. L. ; Diehn, F. E. ; Eckel, L. J. ; Black, David ; Lehman, Vance T ; Lindell, E. P. / Position-related variability of CSF opening pressure measurements. In: American Journal of Neuroradiology. 2013 ; Vol. 34, No. 4. pp. 904-907.
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