Ultrasound for Spine and Nerve Blocks

Neuraxial blockade is employed for a wide breadth of indications. It is often utilized as the ideal primary anesthetic for many surgical indications or for postoperative pain control. Additionally, many neuraxial techniques exist as therapies for patients with chronic pain. Unfortunately, accessing the epidural and subarachnoid space by traditional landmark techniques is often rendered challenging by interpatient spinal anatomy variation and abnormalities such as scoliosis. Furthermore, the upward trend of the typical body mass index of patients in the United States limits the efficacy of said landmark approach. Ultrasonography represents an easily accessible, effective means of visualizing and facilitating access to the target of interest within the spinal canal in these difficult cases. This chapter represents an overview of the relevant anatomical principles and indications for neuraxial blockade and provides a step-by-step guide to the proper ultrasonographic approach for various techniques.