Sonoanatomy of the Thoracic Spine in Adult Volunteers
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: Ultrasonography of the lumbar spine provides information to facilitate the placement of neuraxial anesthesia. Likewise, thoracic spine ultrasound (US) might conceivably improve the quality and safety of thoracic epidural anesthesia. The objective of this study was to advance our understanding in this area by providing a detailed description of the sonoanatomy of the thoracic spine. METHODS: This was a prospective, observational, cohort study in 61 adult volunteers. We performed US scanning of all thoracic interspaces in the right paramedian sagittal oblique (PSO) and transverse median (TM) planes. The images were classified as conclusive and inconclusive, depending on the visibility of ligamentum flavum-dura mater complex (Lf-Dm). The primary outcome was the presence of conclusive images. The secondary outcomes were measurements of various distances between sonoanatomic elements. Data are presented as mean (SD), unless otherwise specified. RESULTS: Overall, the incidence of conclusive images was higher in the PSO than in the TM plane (74.5% [15.4%] versus 37.5% [39.7%], P < 0.001). In the lower thoracic levels, 98% of images were conclusive in both planes, but the number of conclusive images decreased progressively in the upper thoracic levels, more so in the TM than in the PSO plane. The mean depth to Lf-Dm was similar when measured in both PSO (4.0 [0.7] cm) and TM planes (4.1 [0.7] cm). CONCLUSIONS: Ultrasound imaging of the thoracic spine in the PSO plane provides better views of the Lf-Dm compared with the TM plane. A upper incidence of inconclusive sonograms should be expected in the upper thoracic segments, which can be attributed to the narrower acoustic windows at these levels.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".