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To understand spinal ultrasound, a thorough knowledge of lumbar spine anatomy is necessary, as certain bony landmarks can be easily identified: sacrum, spinous processes, articular processes (facet joints) and vertebral bodies. The epidural space is hypo-echoic and often not seen clearly. The ligamentum flavum and posterior dura are commonly seen as a single bright hyperechoic line. Anterior and deep to these structures, the anterior dura and posterior longitudinal ligament can often be seen as being distinct from the vertebral body; the spinal canal lies between these superficial and deeper structures. In neonates and children under six months, the internal architecture of the spinal cord can be clearly seen; this is not so in older children and adults. In http://www.selleckchem.com/products/PF-2341066.html a randomised controlled http://www.selleck.cn/products/3-methyladenine.html trial of 64 children, Willschke et al. [46] compared real-time ultrasound with pre-puncture ultrasound. Catheter placement was successful in all children but was quicker to perform in the real-time ultrasound group: a mean of 162?s compared with 234?s (p? http://www.selleckchem.com/products/r428.html and a lower incidence of severe headaches (2.7% vs 10.0%, p?