Ultrasonography of the lumbar spine for neuraxial and lumbar plexus blocks
Bibliographic record
Abstract
PURPOSE OF REVIEW: Ultrasonography of the spine has evolved into a well described technique that can be applied to facilitate neuraxial and lumbar plexus blockade. RECENT FINDINGS: There is increasing evidence for the clinical benefits of ultrasound imaging prior to administration of neuraxial blockade. Recent randomized controlled trials have shown that efficacy of epidural analgesia is improved, and the technical difficulty of spinal and epidural anaesthesia is reduced. Ultrasound imaging may also permit more accurate prediction of the depth to epidural and intrathecal spaces and more accurate identification of intervertebral levels. The use of ultrasound in lumbar plexus blockade has been described in the context of both preprocedural imaging and real-time needle guidance; however, its clinical benefit in this setting has not yet been clearly established. SUMMARY: Preprocedural ultrasound imaging of the spine may reduce the technical difficulty of neuraxial blockade and also improve clinical efficacy. Similar benefits are expected in the setting of lumbar plexus blockade although there is currently no evidence to confirm this. Real-time ultrasound-guided neuraxial and lumbar plexus blockade are challenging techniques that need further validation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".