Nā ʻano huahana
1. Hiki ke hoʻoneʻe ʻia ka pūhaka. Pono ka mea hana e paʻa i ke poʻo o ka mea maʻi i hoʻohālike ʻia me kekahi lima a paʻa i ka lua wāwae o nā lālā haʻahaʻa ʻelua me ka lima ʻē aʻe e hana i ka iwi kuamoʻo kyphotic a hoʻonui i ka hakahaka vertebral e like me ka hiki ke hoʻopau i ka puncture. 2. Pololei ke ʻano o ka ʻiʻo lumbar a maopopo nā hōʻailona o ka ʻili o ke kino: aia he 1 ~ 5 lumbar vertebrae piha (vertebral body, vertebral arch plate, spinous process), sacrum, sacral hiatus, sacral Angle, superior spinous ligament, interspinous ligament, yellow ligament, dura mater a me omentum, a me subomentum, epidural space a me sacral canal i hana ʻia e nā ʻiʻo ma luna: posterior superior iliac spine, iliac ridge, thoracic spine process a me lumbar spine process hiki ke ʻike maoli ʻia. 3. Hiki ke hana ʻia nā hana aʻe: lumbar anesthesia, lumbar puncture, epidural block, caudal nerve block, sacral nerve block, lumbar sympathetic nerve block 4. ʻOiaʻiʻo hoʻohālikelike o ka lumbar puncture: Ke hiki ka nila puncture i ka ligament melemele i hoʻohālikelike ʻia, piʻi ka pale ʻana a aia kahi manaʻo o ka paʻakikī, a ʻo ka haki ʻana o ka ligament melemele he manaʻo maopopo o ka hoka. ʻO ia hoʻi, i loko o ka epidural space, aia ke kaomi maikaʻi ʻole (i kēia manawa, ʻo ka injection o ka wai anesthetic he epidural anesthesia): e hoʻomau i ka injection i ka nila e puncture i ka dura a me ka omentum, e loaʻa kahi manaʻo lua o ka hāʻule ʻana, ʻo ia hoʻi, i loko o ka subomentum space, e hoʻohālikelike ʻia ke kahe ʻana o ka wai lolo. Hoʻohālikelike ke kaʻina holoʻokoʻa i ke kūlana maoli o ka lumbar puncture lapaʻau.