{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:43:38Z","timestamp":1776185018121,"version":"3.50.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,25]]},"DOI":"10.7759\/cureus.81176","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T19:25:42Z","timestamp":1742930742000},"source":"Crossref","is-referenced-by-count":1,"title":["A Methodical Needle-Over-Needle Guidance (NNG) Approach for Spinal Anesthesia Using a \u201cSuper Introducer\u201d"],"prefix":"10.7759","author":[{"given":"Mahesh","family":"Desilva","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cherry","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick","family":"Wixon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shruthi","family":"Krishnamurthy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200109000-00054","article-title":"Using a spinal needle as an introducer for a spinal needle","volume":"95","author":"Soto R","year":"2001","unstructured":"Soto R, Schultetus RR. Using a spinal needle as an introducer for a spinal needle. Anesthesiology. 2001, 95:814. 10.1097\/00000542-200109000-00054","journal-title":"Anesthesiology"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2010.01699.x","article-title":"Post-dural puncture headache: part I diagnosis, epidemiology, etiology, and pathophysiology","volume":"50","author":"Bezov D","year":"2010","unstructured":"Bezov D, Lipton RB, Ashina S. Post-dural puncture headache: part I diagnosis, epidemiology, etiology, and pathophysiology. Headache. 2010, 50:1144-52. 10.1111\/j.1526-4610.2010.01699.x","journal-title":"Headache"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32451-0","article-title":"Atraumatic versus conventional lumbar puncture needles: a systematic review and meta-analysis","volume":"391","author":"Nath S","year":"2018","unstructured":"Nath S, Koziarz A, Badhiwala JH, et al.. Atraumatic versus conventional lumbar puncture needles: a systematic review and meta-analysis. Lancet. 2018, 391:1197-1204. 10.1016\/S0140-6736(17)32451-0","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000240054.40274.8a","article-title":"Standard vs atraumatic Whitacre needle for diagnostic lumbar puncture: a randomized trial","volume":"67","author":"Lavi R","year":"2006","unstructured":"Lavi R, Yarnitsky D, Rowe JM, Weissman A, Segal D, Avivi I. Standard vs atraumatic Whitacre needle for diagnostic lumbar puncture: a randomized trial. Neurology. 2006, 67:1492-4. 10.1212\/01.wnl.0000240054.40274.8a","journal-title":"Neurology"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7267.986","article-title":"Randomised controlled trial of atraumatic versus standard needles for diagnostic lumbar puncture","volume":"321","author":"Thomas SR","year":"2000","unstructured":"Thomas SR, Jamieson DR, Muir KW. Randomised controlled trial of atraumatic versus standard needles for diagnostic lumbar puncture. BMJ. 2000, 321:986-90. 10.1136\/bmj.321.7267.986","journal-title":"BMJ"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2015.03.009","article-title":"Postdural puncture headache: impact of needle type, a randomized trial","volume":"15","author":"Castrillo A","year":"2015","unstructured":"Castrillo A, Tabernero C, Garc\u00eda-Olmos LM, et al.. Postdural puncture headache: impact of needle type, a randomized trial. Spine J. 2015, 15:1571-6. 10.1016\/j.spinee.2015.03.009","journal-title":"Spine J"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1111\/head.12745","article-title":"Lower incidence of postdural puncture headache using whitacre spinal needles after spinal anesthesia: a meta-analysis","volume":"56","author":"Zhang D","year":"2016","unstructured":"Zhang D, Chen L, Chen X, Wang X, Li Y, Ning G, Feng S. Lower incidence of postdural puncture headache using whitacre spinal needles after spinal anesthesia: a meta-analysis. Headache. 2016, 56:501-10. 10.1111\/head.12745","journal-title":"Headache"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeg231","article-title":"Post-dural puncture headache: pathogenesis, prevention and treatment","volume":"91","author":"Turnbull DK","year":"2003","unstructured":"Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 2003, 91:718-29. 10.1093\/bja\/aeg231","journal-title":"Br J Anaesth"},{"key":"ref9","doi-asserted-by":"crossref","DOI":"10.1016\/S1098-7339(06)80058-1","article-title":"Role of needle gauge and tip configuration in the production of lumbar puncture headache","volume":"22","author":"Lambert DH","year":"1997","unstructured":"Lambert DH, Hurley RJ, Hertwig L, Datta S. Role of needle gauge and tip configuration in the production of lumbar puncture headache. Reg Anesth. 1997, 22:66-72.","journal-title":"Reg Anesth"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.4103\/0259-1162.94757","article-title":"Do pencil-point spinal needles decrease the incidence of postdural puncture headache in reality? A comparative study between pencil-point 25G Whitacre and cutting-beveled 25G Quincke spinal needles in 320 obstetric patients","volume":"5","author":"Pal A","year":"2011","unstructured":"Pal A, Acharya A, Pal ND, Dawn S, Biswas J. Do pencil-point spinal needles decrease the incidence of postdural puncture headache in reality? A comparative study between pencil-point 25G Whitacre and cutting-beveled 25G Quincke spinal needles in 320 obstetric patients. Anesth Essays Res. 2011, 5:162-6. 10.4103\/0259-1162.94757","journal-title":"Anesth Essays Res"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S112659","article-title":"Post-dural puncture headache [RETRACTED]","volume":"9","author":"Ghaleb A","year":"2016","unstructured":"Ghaleb A, Khorasani A, Mangar D. Post-dural puncture headache [RETRACTED]. Int J Gen Med. 2016, 9:173. 10.2147\/IJGM.S112659","journal-title":"Int J Gen Med"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199602000-00014","article-title":"The effects of needle type, gauge, and tip bend on spinal needle deflection","volume":"82","author":"Sitzman BT","year":"1996","unstructured":"Sitzman BT, Uncles DR. The effects of needle type, gauge, and tip bend on spinal needle deflection. Anesth Analg. 1996, 82:297-301. 10.1097\/00000539-199602000-00014","journal-title":"Anesth Analg"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2014.01.008","article-title":"Broken spinal needle: case report and review of the literature","volume":"26","author":"Martinello C","year":"2014","unstructured":"Martinello C, Rubio R, Hurwitz E, Simon M, Vadhera RB. Broken spinal needle: case report and review of the literature. J Clin Anesth. 2014, 26:321-4. 10.1016\/j.jclinane.2014.01.008","journal-title":"J Clin Anesth"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2006.08.004","article-title":"Broken needle complicating spinal anaesthesia","volume":"16","author":"Mehta M","year":"2007","unstructured":"Mehta M. Broken needle complicating spinal anaesthesia. Int J Obstet Anesth. 2007, 16:94-5. 10.1016\/j.ijoa.2006.08.004","journal-title":"Int J Obstet Anesth"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2013.08.006","article-title":"Removal of a fractured spinal needle fragment six months after caesarean section","volume":"23","author":"Lonn\u00e9e H","year":"2014","unstructured":"Lonn\u00e9e H, Fasting S. Removal of a fractured spinal needle fragment six months after caesarean section. Int J Obstet Anesth. 2014, 23:95-6. 10.1016\/j.ijoa.2013.08.006","journal-title":"Int J Obstet Anesth"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.40241","article-title":"A systemic review of spinal needles broken during neuraxial anesthesia","volume":"15","author":"Alsharif TH","year":"2023","unstructured":"Alsharif TH, Gronfula AG, Turkistani S, Alshmlany AM, Sharourou Z, Aboueleneein H, Alhamied F. A systemic review of spinal needles broken during neuraxial anesthesia. Cureus. 2023, 15:e40241. 10.7759\/cureus.40241","journal-title":"Cureus"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2014.12.020","article-title":"Changing the needle for lumbar punctures: results from a prospective study","volume":"130","author":"Engedal TS","year":"2015","unstructured":"Engedal TS, \u00d8rding H, Vilholm OJ. Changing the needle for lumbar punctures: results from a prospective study. Clin Neurol Neurosurg. 2015, 130:74-9. 10.1016\/j.clineuro.2014.12.020","journal-title":"Clin Neurol Neurosurg"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2004.03976.x","article-title":"The history of spinal needles: getting to the point","volume":"59","author":"Calthorpe N","year":"2004","unstructured":"Calthorpe N. The history of spinal needles: getting to the point. Anaesthesia. 2004, 59:1231-41. 10.1111\/j.1365-2044.2004.03976.x","journal-title":"Anaesthesia"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2000.01157.x","article-title":"Combined spinal-epidural techniques","volume":"55","author":"Cook TM","year":"2000","unstructured":"Cook TM. Combined spinal-epidural techniques. Anaesthesia. 2000, 55:42-64. 10.1046\/j.1365-2044.2000.01157.x","journal-title":"Anaesthesia"},{"key":"ref20","unstructured":"Difficult spinal in obese patient - crash course with Dr. Hadzic. (2021). https.\/\/youtu.be\/t7gGkGn13CM?si=q-rhc9yVXaftZTrG."}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/349419-a-methodical-needle-over-needle-guidance-nng-approach-for-spinal-anesthesia-using-a-super-introducer","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T19:25:44Z","timestamp":1742930744000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/349419-a-methodical-needle-over-needle-guidance-nng-approach-for-spinal-anesthesia-using-a-super-introducer"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,25]]},"references-count":20,"URL":"https:\/\/doi.org\/10.7759\/cureus.81176","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2025,3,25]]}}}