Computer aided detection of Lumbar spine landmarks for ultrasound guided Lumbar punctures and epidurals

Lumbar puncture (LP) procedures are facilitated by palpation-based techniques in which the needle insertion location is determined by palpating spinous processes to identify the vertebral level and midline. Not surprisingly, the efficacy of this technique decreases in obese patients and in patients with spinal deformities. Ultrasound imaging significantly improves LP success rates in these difficult patients, but clinical adoption has been limited by poor image quality of bone anatomy and practical difficulties associated with acquiring and interpreting ultrasound images of the spine. In this work, we designed a handheld ultrasound system with enhanced bone image quality and automated spine landmark detection as a means to circumvent technical and practical limitations of neuraxial ultrasound. We present the first clinical evaluation of bone image quality and accuracy of automated spine landmark detection to establish feasibility of the technique.