Lumbar MBB with AP approach?

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I oblique 10 to the left, then once placed I oblique 10 to the right and they to get my target points on the right lined up, plus the needle tips on the left to verify position from a second angle. Even if they looked great in the first view the second does often show them to be a little too shallow or too inferior.
if patient is that heavy will probably be too heavy for table; follow IPSIS guidelines for best results - shortcuts lead to bad outcomes
 
Two in my group do this and their needle tips are all over and around the pedicle, usually nowhere close to the superolateral quadrant. Sometimes needle tip is on the chin, neck or ear of the Scottie dog. It’s concerning to say the least
 
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