{"id":4527,"date":"2019-03-22t15:56:44","date_gmt":"2019-03-22t04:56:44","guid":{"rendered":"\/\/www.iolishoes.com\/?page_id=4527"},"modified":"2021-07-01t23:32:00","modified_gmt":"2021-07-01t13:32:00","slug":"neonatal-spine-normal","status":"publish","type":"page","link":"\/\/www.iolishoes.com\/neonatal-spine-normal\/","title":{"rendered":"neonatal spine normal"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"4527\" class=\"elementor elementor-4527\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-05afd2e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"05afd2e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c4b1d51\" data-id=\"c4b1d51\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1e4fd00e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1e4fd00e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1ec092ee\" data-id=\"1ec092ee\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-771bd4a6 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"771bd4a6\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7c330ac elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7c330ac\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2ed1efe\" data-id=\"2ed1efe\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3ddf94d elementor-widget elementor-widget-text-editor\" data-id=\"3ddf94d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>in the neonate, the cartilaginous vertebral components make ultrasound excellent for:<\/p><ul><li>assessing suspected neural tube defects. particularly closed defects.<\/li><li>guiding lumbar puncture and spinal intervention.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-54379c2 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"54379c2\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-1458c2ef\" data-id=\"1458c2ef\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7c5ad61 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"7c5ad61\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<a class=\"elementor-flip-box__layer elementor-flip-box__back\" href=\"#elementor-action%3aaction%3dlightbox%26settings%3deyj1cmwioijodhrwolwvxc91bhryyxnvdw5kcgflzglhlmnvbvwvd3aty29udgvudfwvdxbsb2fkc1wvmjaymvwvmdzcl25lb25hdgfslxnwaw5llwfuyxrvbxktc2nlbwf0awmuanbniiwidhlwzsi6imltywdliiwidgl0bguioijcyxnpyybhbmf0b215ig9mihrozsbuzw9uyxrhbcbzcgluzswgy29yzcbhbmqgbmvydmugcm9vdhmuin0%3d\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-a6b38fa\" data-id=\"a6b38fa\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-319f475e elementor-widget elementor-widget-text-editor\" data-id=\"319f475e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><em><strong>anatomy overview<\/strong><\/em><\/p><ul><li>the spinal cord terminates at approximately l2-3 at conus medullaris.<\/li><li>the central canal of the cord continues to the coccyx as filum terminale.<\/li><li>nerve roots arise from the cord along it&#8217;s length and are abundant beyond conus, as cauda equinna (&#8220;horses tail&#8221;).<\/li><li>\u00a0<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-563001ff elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"563001ff\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-16bda59e\" data-id=\"16bda59e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1e526531 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"1e526531\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-50c1b227 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"50c1b227\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-fe87429\" data-id=\"fe87429\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1f4a7980 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"1f4a7980\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<a class=\"elementor-flip-box__layer elementor-flip-box__back\" href=\"#elementor-action%3aaction%3dlightbox%26settings%3deyj1cmwioijodhrwolwvxc91bhryyxnvdw5kcgflzglhlmnvbvwvd3aty29udgvudfwvdxbsb2fkc1wvmjaymvwvmdzcl3vsdhjhc291bmqtbm9ybwfslw5lb25hdgfslxnwaw5llxnhz2l0dgfslwhslmpwzyisinr5cguioijpbwfnzsisinrpdgxlijoivwx0cmfzb3vuzcbvzibhig5vcm1hbcbuzw9uyxrhbcbzcgluzsbzywdpdhrhbgx5igf0ihrozsbszxzlbcbvzibjb251cybtzwr1bgxhcmlzlij9\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7688fb11 elementor-widget elementor-widget-text-editor\" data-id=\"7688fb11\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>ultrasound of a normal neonatal spine sagittally at the level of conus medullaris.<\/p><p>the central canal of the cord continues distally as filum terminale.<\/p><p>note that the nerve roots in cauda equina are laying in the dependant aspect of the thecal sac.<\/p><p>avoid using the spinous processes to calculate level because they angle caudally.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-231c040b\" data-id=\"231c040b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5d37531f elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"5d37531f\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4262c7f1 elementor-widget elementor-widget-text-editor\" data-id=\"4262c7f1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>sagittal neonatal sacrum ultrasound image.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a38e09c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a38e09c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-3635f35\" data-id=\"3635f35\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2061585 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"2061585\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-99520b1 elementor-widget elementor-widget-text-editor\" data-id=\"99520b1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>ultrasound of a normal neonatal spine. transverse plane.<\/p><p>image sequence from superior to inferior.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-d45a325\" data-id=\"d45a325\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ee5cf15 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"ee5cf15\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dfc9b4c elementor-widget elementor-widget-text-editor\" data-id=\"dfc9b4c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>\u00a0schematic of the neonatal spine showing approximate transverse ultrasound probe levels corresponding to the adjacent images.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3b26d5fd elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3b26d5fd\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3ebb4857\" data-id=\"3ebb4857\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1b912c73 elementor-widget elementor-widget-ep-image-comparison\" data-id=\"1b912c73\" data-element_type=\"widget\" data-widget_type=\"ep-image-comparison.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div id=\"ep-ic-1b912c73\" data-offset=\"0.5\" data-orientation=\"horizontal\" data-before-label=\"before\" data-after-label=\"after\" data-overlay=\"false\" data-hover=\"false\" data-handle=\"false\" data-click=\"true\">\n\t\t\t\t\t<img decoding=\"async\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/07\/panorama-neonatal-spine.jpg\" title=\"panorama neonatal spine\" alt=\"panorama neonatal spine\" loading=\"lazy\" \/>\t\t\t\t\t<img decoding=\"async\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2021\/07\/panorama-neonatal-spine-hl.jpg\" title=\"panorama neonatal spine hl\" alt=\"panorama neonatal spine hl\" loading=\"lazy\" \/>\t\t\t\t<\/div>\n\t\t\t\t<script>\n\t\t\t\t\tjquery(document).ready(function () {\n\t\t\t\t\t\tjquery(document).trigger('elementor\/render\/ep_image_comparison', '#ep-ic-1b912c73');\n\t\t\t\t\t});\n\t\t\t\t<\/script>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-696dd183 elementor-widget elementor-widget-text-editor\" data-id=\"696dd183\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>panoramic view from lower thoracic to the buttock<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7b3dbaa4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7b3dbaa4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-59b05a9b\" data-id=\"59b05a9b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9f14801 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"9f14801\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-66e4daed elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"66e4daed\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-174d5896\" data-id=\"174d5896\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1466535 elementor-grid-3 elementor-grid-tablet-2 elementor-grid-mobile-1 pp-video-gallery-content-below-video pp-swiper-slider-pagination-outside elementor-widget elementor-widget-pp-video-gallery\" data-id=\"1466535\" data-element_type=\"widget\" data-settings=\"{&quot;layout&quot;:&quot;carousel&quot;,&quot;pause_on_hover&quot;:&quot;yes&quot;}\" data-widget_type=\"pp-video-gallery.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-gallery-container pp-video-gallery-carousel\">\n\t\t\t<div class=\"pp-video-gallery-wrap swiper-container-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"pp-video-gallery pp-swiper-slider swiper\" data-action=\"lightbox\" data-slider-settings=\"{&quot;speed&quot;:500,&quot;slides_per_view&quot;:3,&quot;slides_to_scroll&quot;:1,&quot;space_between&quot;:20,&quot;auto_height&quot;:&quot;yes&quot;,&quot;loop&quot;:&quot;yes&quot;,&quot;autoplay&quot;:&quot;yes&quot;,&quot;autoplay_speed&quot;:999999,&quot;pagination&quot;:&quot;bullets&quot;,&quot;show_arrows&quot;:true,&quot;slides_per_view_mobile&quot;:1,&quot;space_between_mobile&quot;:10,&quot;slides_per_view_tablet&quot;:2,&quot;space_between_tablet&quot;:10}\" dir=\"ltr\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"swiper-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"swiper-slide\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-1466535\" href=\"https:\/\/vimeo.com\/87564603\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/465722462-1e2d04b430f42bce260cb31589d8b238d44bf7d228987a70e37136c774a32d43-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tultrasound neonatal spine ts superior to conus\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\ttransverse ultrasound cephalad to conus showing the nerve roots around the normal spinal cord.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"swiper-slide\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-1466535\" href=\"https:\/\/vimeo.com\/87564605\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/465722072-3eebfaaf5352f6b77d32aa13dc910785c2ac5c94b8300136284c8fe604ad9256-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tultrasound neonatal spine ts at conus\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\ttransverse ultrasound of normal neonatal spine at the tip of conus showing the normal nerve root oscillations.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"swiper-slide\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-1466535\" href=\"https:\/\/vimeo.com\/87564608\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/465721438-96a2d0934e4ec1a904f8b3839c2257d78b7024b1d0f50f0a2f83761920c15753-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tultrasound neonatal spine ts inferior to conus\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\ttransverse ultrasound view of the inferior normal neonatal spine. note the normal cardiac and respiratory oscillation of the nerve roots.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"swiper-slide\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-1466535\" href=\"https:\/\/vimeo.com\/87564607\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/465721814-fa31e79ddbd4b70cd6f678adacb3b5628fbadabe1008a7ae87676c8d218a5f9d-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tultrasound neonatal spine ls at conus\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\tsagittal ultrasound of the neonatal spine at conus showing , filum and the normal nerve roots.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"swiper-slide\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-1466535\" href=\"https:\/\/vimeo.com\/87564611\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/1176060792-167607bb0588dbcfcba93ee6126ab3c6e3db37569df4d29907fa42adad9180d0-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tneonatal spine ultrasound normal sagittal\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\tlongitudinal ultrasound of the neonatal spine from the sacrum up to the lower thoracic region. the nerve rooots and filum are seen converging towards conus medullaris and then along the cord.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<!-- add pagination -->\n\t\t\t<div class=\"swiper-pagination swiper-pagination-1466535\"><\/div>\n\t\t\t\t\t\t\t<div class=\"pp-slider-arrow elementor-swiper-button-prev swiper-button-prev-1466535\" role=\"button\" tabindex=\"0\">\n\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-angle-left\"><\/i>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"pp-slider-arrow elementor-swiper-button-next swiper-button-next-1466535\" role=\"button\" tabindex=\"0\">\n\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-angle-right\"><\/i>\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-23a91b5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"23a91b5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4461ef1\" data-id=\"4461ef1\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b7204ba elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"b7204ba\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9eb750b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9eb750b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6acd7a2f\" data-id=\"6acd7a2f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-11be8b17 elementor-widget elementor-widget-text-editor\" data-id=\"11be8b17\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1 style=\"text-align: center;\">scan protocol<\/h1>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7f82cec elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7f82cec\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-44fbe6da\" data-id=\"44fbe6da\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3b44e97d elementor-widget elementor-widget-text-editor\" data-id=\"3b44e97d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"role_of_ultrasound\"><\/span>role of ultrasound<span class=\"ez-toc-section-end\"><\/span><\/h3><p>ultrasound is a cost effective, readily accessible tool to investigate the neonatal spine.<\/p><p>it is the premier tool for screening for most suspected neonatal spinal abnormalities from the first few hours of life.<\/p><p>it requires no ionizing radiation or sedation. generally, ultrasound can be used as a stand alone tool to investigate for spinabifida occulta, cord tethering, masses, infection and the degree of clinically obvious abnormalities.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a4455db elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a4455db\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ec21105\" data-id=\"ec21105\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b3d5e7f elementor-widget elementor-widget-text-editor\" data-id=\"b3d5e7f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"indications\"><\/span>indications<span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>posterior mid-line cysts\/masses<\/li><li>mid-line skin dimples &#8211; often called a &#8216;sacral pit&#8217;.<\/li><\/ul><p>&#8211; babies with tiny mid-line skin defects low in the sacro-coccygeal region at the upper buttock cleft, will generally be normal.<\/p><p>&#8211; larger or higher clefts are more likely associated with spinal abnormalities.<\/p><ul><li>tufts of hair<\/li><li>visible haemangioma \/ skin discolouration<\/li><li>anal atresia \/ stenosis<\/li><li>guidance for lumbar puncture<\/li><li>post injury \/ trauma<\/li><li>post surgical &#8211; follow up or complication<\/li><li>infection \/ abscess<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-51bcd5c0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"51bcd5c0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-42495fe0\" data-id=\"42495fe0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5ae27617 elementor-widget elementor-widget-text-editor\" data-id=\"5ae27617\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"limitations\"><\/span>limitations<span class=\"ez-toc-section-end\"><\/span><\/h3><p>caution needs to be exercised with open (or near-open) neural tube defects. if scanning is required in these circumstances, sterile technique should be observed, ideally with a sterile gel stand-off so minimal pressure is required. sterile water\/saline may be appropriate rather than gel. this should be discussed with the managing physician.<\/p><p><em>generally, if available, mri is the modality of choice for open neural tube defects, including small csf leaks.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6adf25ec elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6adf25ec\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-32a25b16\" data-id=\"32a25b16\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-79fc0d94 elementor-widget elementor-widget-text-editor\" data-id=\"79fc0d94\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"patient_preparation\"><\/span>patient preparation<span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>prone, head, slightly higher than the feet to better fill the lower csf space.<\/li><li>a rolled towel (or similar) under the baby&#8217;s abdomen to slightly widen the posterior inter-spinous spaces.<\/li><\/ul><p>\u00a0if using ultrasound to guide a spinal tap, the more erect you are able to position the baby, the more csf will be visible, avoiding a &#8216;dry-tap&#8217;.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-64a9d31 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"64a9d31\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-57e9951c\" data-id=\"57e9951c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-14ebed06 elementor-widget elementor-widget-text-editor\" data-id=\"14ebed06\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"equipment_setup\"><\/span>equipment setup<span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>a high frequency, linear array transducer. minimum 8mhz. ideally a large footprint to offer more length of the image field.<\/li><li>you may also require a smaller footprint, higher frequency probe to assess fistulae or for procedural needle guidance.<\/li><li>&#8216;panorama&#8217;\u00a0 function is useful to demonstrate the relationship of anatomy\/pathology.<\/li><li><ul><li>warm room.<\/li><li>warm gel.<\/li><li>warm hands.<\/li><li>dim lighting<\/li><li>bribery: a soothing parent or assistant, food, pacifier (dummy). glycerine (glucose syrup) can be useful to dip the pacifier, or a maternal finger, in to encourage quiet sucking..<\/li><\/ul><p><em>remember, a warm, quiet relaxed baby leads to a quicker easier scan with more accurate results.<\/em><\/p><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-236f4f95 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"236f4f95\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-52ca9c13\" data-id=\"52ca9c13\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-337de595 elementor-widget elementor-widget-text-editor\" data-id=\"337de595\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"common_pathology\"><\/span>common pathology<span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>spina bifida and its sequelae.<\/li><li>low conus medullaris &#8211; cord tethering<\/li><li>arachnoid cysts \/ pseudomenigoceles<\/li><li>intra-thecal lipomata<\/li><li>skin &#8211; thecal sac fistula<\/li><li>haemangioma<\/li><li>haematoma<\/li><li>complicated csf ( infection or bleeding)<\/li><li>vertebral agenesis, malformation or malalignment<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e3cc9c5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e3cc9c5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6489272a\" data-id=\"6489272a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1b9a008a elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"1b9a008a\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-11a00647 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"11a00647\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2bf7a256\" data-id=\"2bf7a256\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2d7da281 elementor-widget elementor-widget-text-editor\" data-id=\"2d7da281\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1 style=\"text-align: center;\">scanning technique<\/h1>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-de35684 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"de35684\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2998511\" data-id=\"2998511\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3c49519 elementor-widget elementor-widget-text-editor\" data-id=\"3c49519\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>begin with a survey scan (this will take less than a minute) followed by a detailed assessment.<\/strong><\/p><h2><span class=\"ez-toc-section\" id=\"survey\"><\/span>survey<span class=\"ez-toc-section-end\"><\/span><\/h2><ul><li>firstly in transverse, sweep from the mid thoracic region to the sacro-coccygeal region.<\/li><\/ul><p>&#8211; are the posterior neural arches, paired and uniform.<\/p><p>&#8211; are there any obvious, gross pathologies.<\/p><ul><li>next, a sagittal sweep from one side to the other.<\/li><\/ul><p>&#8211; depending on your transducer footprint as to how many passes you require to cover the anatomy.<\/p><p>&#8211; are there any obvious, gross pathologies.<\/p><h2><span class=\"ez-toc-section\" id=\"detail_scanning\"><\/span>detail scanning<span class=\"ez-toc-section-end\"><\/span><\/h2><ul><li><strong><strong>is the cord and csf space uniform in shape?<\/strong><\/strong><p>there are two primary methods to determine the level of conus.<\/p><ol><li>identify the 12th rib, and thus t12 and count down.<\/li><li>identify the lumbo-sacral junction and count up from l5.\u00a0<\/li><\/ol><p>normal conus position is:\u00a0no lower than the top of l3 in a term infant or the bottom l3 in a pre-term infant.<\/p><p>&#8211; be cautious of variation in the number of lumbar vertebrae.<\/p><p>* if the level cannot be accurately determined, a radio-opaque marker (ball bearing or similar) may by fixed to the skin over conus, and a plain x-ray performed. this should only be performed if there is sufficient clinical concern. ensure the baby is flat when the marker is applied to eliminate error from relative movement of the skin-spine.<\/p><ul><li><strong>identify filum terminale.<\/strong><\/li><\/ul><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7891d6ea elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7891d6ea\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-49bc63cc\" data-id=\"49bc63cc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-53b623e7 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"53b623e7\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-259f7059 elementor-widget elementor-widget-text-editor\" data-id=\"259f7059\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>normal filum terminale ultrasound image.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5265c8f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5265c8f\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2a5258b\" data-id=\"2a5258b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0aa808e elementor-widget elementor-widget-text-editor\" data-id=\"0aa808e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>&#8211; it should appear as thin closely related parallel lines extending from conus to the lowest reaches of the thecal space (approximately s2).<\/p><p>&#8211; filum is approximately 2mm in diameter.<\/p><p>&#8211; a filar cyst (ventriclus terminalis) is an commonly seen anatomical variant. it will be seen as a focal fusiform thickening of filum, usually close to conus.<\/p><p><br \/><strong>examine cauda equina<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5cd3a92d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5cd3a92d\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-6a375ee2\" data-id=\"6a375ee2\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-401a6fd1 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"401a6fd1\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-23cdf122 elementor-widget elementor-widget-text-editor\" data-id=\"23cdf122\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>transverse ultrasound view of normal symmetry of cauda equina surrounding the tip of conus and the filum.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-a89adc6\" data-id=\"a89adc6\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3e2d2ff5 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"3e2d2ff5\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3a981f32 elementor-widget elementor-widget-text-editor\" data-id=\"3a981f32\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>longitudinal ultrasound view of normal cauda equina<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d157284 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d157284\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7addb09\" data-id=\"7addb09\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a901f20 elementor-widget elementor-widget-text-editor\" data-id=\"a901f20\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>the nerve roots comprising cauda equina should lie in the dependent portion of the thecal sac.<\/p><p>&#8211; should see gentle oscillating movements with the baby&#8217;s cardiac pulsations and respiration.<\/p><p>&#8211; symmetry. look for asymmetry indicative of pathology (space occupying mass or\u00a0 unilateral abnormality)<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-50bb9f5e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"50bb9f5e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-59e38277\" data-id=\"59e38277\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-107ccac4 elementor-grid-2 elementor-grid-tablet-2 elementor-grid-mobile-1 pp-video-gallery-content-below-video elementor-widget elementor-widget-pp-video-gallery\" data-id=\"107ccac4\" data-element_type=\"widget\" data-settings=\"{&quot;layout&quot;:&quot;grid&quot;}\" data-widget_type=\"pp-video-gallery.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-gallery-container pp-video-gallery-grid\">\n\t\t\t<div class=\"pp-video-gallery-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"pp-video-gallery elementor-grid\" data-action=\"lightbox\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-107ccac4\" href=\"https:\/\/vimeo.com\/568889346\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/1176511538-6c97f36247bd5a6bc20ac5126a1c772bffa4292eab180b6d3bbee7fd54adb998-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tultrasound neonatal spine normal conus\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\ttransverse ultrasound at the tip of conus medullaris. filum terminale can be seen centrally between the cauda equina bundles.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-107ccac4\" href=\"https:\/\/vimeo.com\/568890125\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/1176508895-adc8b666b143ca5466ae749e7634f9127eea801ea134d30311612b4f2262f94a-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tultrasound neonatal spine normal inferior\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\tthe normal oscillations of the nerve roots of cauda equina in the dependant aspect of the thecal sac\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7b93e97 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7b93e97\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-436018a\" data-id=\"436018a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-21aa823 elementor-widget elementor-widget-text-editor\" data-id=\"21aa823\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>the nerve roots comprising cauda equina should lie in the dependent portion of the thecal sac.<\/p><p>&#8211; should see gentle oscillating movements with the baby&#8217;s cardiac pulsations and respiration.<\/p><p>&#8211; symmetry. look for asymmetry indicative of pathology (space occupying mass or\u00a0 unilateral abnormality)<\/p><ul><li><strong>examine the bony anatomy<\/strong><\/li><\/ul><p>&#8211; particular attention should be paid to the integrity the posterior neural arches in the transverse plane.<\/p><p>&#8211; check the vertebral bodies for alignment, shape and symmetry in both transverse and sagittal planes.<\/p><ul><li><strong>examine the dimple<\/strong><\/li><\/ul><p>&#8211; if there is a dimple or skin defect, this should be carefully examined with a high frequency probe to look for a skin &#8211; thecal sac fistula.<\/p><p>&#8211; use minimal pressure so as not to compress and thus obscure a fistula tract.<\/p><p>&#8211; an anatomical variant is a thin hypoechoic fibrous band from the dimple to the coccyx. this is of no clinical signifigance. most true fitsulae will be higher than the coccygeal region.<\/p><p>&#8211; if csf is leaking, an mri should be performed.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-751c7ac6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"751c7ac6\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2fbc5e1a\" data-id=\"2fbc5e1a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4c5d724a elementor-widget elementor-widget-text-editor\" data-id=\"4c5d724a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"basic_hardcopy_imaging\"><\/span>basic hardcopy imaging<span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>t12 &#8211; s2 posterior bony arches in transverse.<\/li><li>transverse cord, conus and nerve roots.<\/li><li>longitudinal distal cord with conus and labelled vertebral numbers (t12, l1, l2 etc).<\/li><li>longitudinal at the &#8216;dimple&#8217;.<\/li><\/ul><p>&#8211; if necessary, m-mode (or capturing a cine loop) can be used to document normal or abnormal motion of the cord or nerve roots.<\/p><p>&#8211; appropriate documentation of any pathology identified.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2ced6107 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2ced6107\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6e7ba7e6\" data-id=\"6e7ba7e6\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2d4b8a4b elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"2d4b8a4b\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>in the neonate, the cartilaginous vertebral components make ultrasound excellent for: assessing suspected neural tube defects. particularly closed defects. guiding lumbar puncture and spinal intervention. anatomy overview the spinal cord terminates at approximately l2-3 at conus medullaris. the central canal of the cord continues to the coccyx as filum terminale. nerve roots arise from the [&hellip;]<\/p>\n","protected":false},"author":10,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"tags":[],"class_list":["post-4527","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages\/4527","targethints":{"allow":["get"]}}],"collection":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/users\/10"}],"replies":[{"embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/comments?post=4527"}],"version-history":[{"count":0,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages\/4527\/revisions"}],"wp:attachment":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/media?parent=4527"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/tags?post=4527"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}