Case series demonstrates successful real-time ultrasound-guided lumbar puncture in patients with altered spinal anatomy, indicating its utility when landmark-based approaches fail.
Lumbar puncture is an important clinical technique.In patients with spinal deformities or those who undergo lumbar surgery，using surface anatomical landmarks for localization is often challenging，and real-time ultrasound guidance can be employed to complete the procedure.This article reports two representative difficult cases of lumbar puncture and provides a detailed review and summary of the application and clinical experience of ultrasound-guided lumbar puncture in these types of patients.
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Chen et al. (2026) studied this question.
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