Palpation and ACCURO for Placing Spinal in C-section
Palpation and ACCURO for Placing Spinal in C-section
The Accuro is a three dimensional handheld ultrasound device. This device uses sound waves to
 create pictures of the spine in three dimensions. This may allow the physician to view the
 spine in more detail for procedures such as spinal anesthesia and other diagnostic
 procedures.

 We aim to assess the benefit of using both the Accuro and traditional landmark palpation
 technique to determine accurate spinal level in women who undergo cesarean section. This
 study will also assess provider preference for use of both Accuro and palpation compared with
 palpation alone or use of Accuro alone.

 Anesthesia Providers will first identify the L4/L5 space using the traditional technique of
 palpating the iliac crests to estimate spinal level, which will be marked with a single dot
 from a marking pen. The provider will then use the Accuro 3000 to identify the L4/L5
 interspace.

 Results will be compared to results obtained in IRB 18070 "Handheld 3D lumbar spine
 navigation: A clinical validation study RM002" where subjects who were undergoing a C-section
 were randomized to either palpation or Accuro alone.
Inclusion Criteria:

 -  • Patients between the ages of 18 and 45 presenting for a C-section delivery or
 scheduled for elective Cesarean section

 -  ASA-1, ASA-2, and ASA-3

 -  Patients with no known back deformities

 -  Ability to sit upright for spinal placement

 -  No prior lumbar surgery

 -  No allergies to ultrasound gel

 Exclusion Criteria:

 -  • Unable or unwilling to give informed consent