"Spinning on the AC" - US Imaging for Spinals & LPs in Challenging Anatomy

The anterior complex (AC) is a key sonographic landmark in ultrasound imaging for neuraxial blocks and lumbar puncture. If the AC is visible, the ultrasound beam is penetrating the canal through a soft-tissue window - and a needle can follow this same path to reach the epidural or intrathecal space.
The "Spinning on the AC" maneuver utilizes this principle, to mark a paraspinous needle trajectory. This is a refinement of the scanning-marking technique for a paraspinous approach described in another video ( • Ultrasound Imaging for... ), and can enhance accuracy; especially where the AC is visible in the parasagittal oblique (PSO) view but not so well in the transverse midline (TM) view.
General advantages of using and mastering the paraspinous (paramedian) approach vs a midline needle approach are described here - • Paraspinous (Paramedia...

[@chennakesavulamadhukar4991]

Humble thanks to you sir 🙏🙏

[@claudiovargasmd.4861]

Hi Professor: brilliant new presentation, as usual. Keep learning from you as i personally told you in recent Congreso Chileno de Anestesiologia. Big hug from Concepción,Chile.🇨🇱

[@akshayuttarwar3240]

Great video..
It's so nice to learn from you every time.
Although it's distant, it's still effective.
Thanks again

[@eliobelf]

Amazing video professor!