Mathematical Models for the Skin to Lumbosacral Epidural Distance in Dogs: A Cadaveric Computed-Tomography Study

Animals (Basel). 2021 Oct 15;11(10):2974. doi: 10.3390/ani11102974.

Abstract

This study aimed to validate previously published computed tomography (CT) derived mathematical equations with the true skin to lumbosacral epidural distance (SLED) in dog cadavers. Phase 1: The lumbar region of 11 dog cadavers were scanned in sternal recumbency to determine the effect of cranial, neutral, and caudal pelvic limb positioning on the CT derived lumbosacral epidural distance (CLED). Phase 2: The epidural space was determined using contrast epidurography, and the SLED was analysed against the mathematical equations using a body condition score (BCS) and either the cadaveric occipital-coccygeal length (OCL) (Equation (1): = 7.3 + 0.05*OCL + 16.45*BCS) or the ilium wing distance (IWD) (Equation (2): = 3.5 + 0.56*IWD + 16.6*BCS). There were no differences detected between the pelvic limb positions and the CLED. Both equations demonstrated strong correlations (Equation (1): r = 0.7196; Equation (2): r = 0.7590) with the SLED. The level of agreement was greater for Equation (1) than with Equation (2) (concordance coefficient 0.6061 and 0.3752, respectively). Equation (1) also demonstrated a closer fit to the concordance line compared with Equation (2) (bias correction factor 0.8422 and 0.4960, respectively). Further studies in live anaesthetised dogs will help to determine the usefulness of the pre-procedural knowledge when performing lumbosacral epidurals.

Keywords: anaesthesia; computed tomography; epidural; epidurography; ligamentum flavum; locoregional; lumbosacral; mathematical; modelling.