“…This localization process may be problematic when patients are obese, pregnant, or have spinal abnormalities, including misalignment or degenerative changes [3][4][5][6][7]. Ultrasound can be used to gain a more accurate understanding of a patient's spinal anatomy, leading to fewer needle insertion attempts and spinal needle manipulations, and improve patient satisfaction [3,5,6,[8][9][10][11][12][13][14][15][16][17][18]. Further, a decrease in the number of needle insertion attempts has been shown to correlate with a decreased incidence of postdural puncture headache [19], new-onset persistent low-back pain [20], and puncture site bleeding [21].…”