Ligament, nerve, and blood vessel anatomy of the lateral zone of the lumbar intervertebral foramina

Yuan, Shiguo; Wen, Youliang; Zhang, Pei; Li, Yikai

doi:10.1007/s00264-015-2831-6

Cited by 23 publications

(14 citation statements)

References 20 publications

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“…[ 18 ] Biboulet explained that the drug may infiltrate the epidural space from the intervertebral foramen when injected in the paravertebral region. [ 19 , 20 ] This explanation suggests that intraspinal drug infiltration could be avoided to some extent by injecting the drug away from the intervertebral foramen. To date, there has been no report on the incidence of epidural spread in the double-guided short-axis in-plane method.…”

Section: Discussionmentioning

confidence: 99%

Comparison of lumbar plexus block using the short axis in-plane method at the plane of the transverse process and at the articular process: a randomized controlled trial

et al. 2018

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BackgroundAlthough the safety and effectiveness of the short-axis in-plane method has been confirmed for lumbar plexus block, the operation is difficult and has a high rate of epidural spread at the plane of the articular process. Therefore, we developed a new in-plane technique, called the beach chair method, which displays images from the transverse process. We compared the operative difficulty and incidence of epidural spread of the beach chair method with those of the control method (at the plane of the articular process) in this randomized controlled clinical trial.MethodsSixty patients, aged 18 to 75 years, scheduled for unilateral arthroscopic knee surgery were randomized to receive double-guided lumbar plexus block by the beach chair method (n = 30) or the control method (n = 30) with 30 ml 0.5% ropivacaine hydrochloride; all patients received a sciatic nerve block with 10 ml 1% lidocaine hydrochloride and 10 ml 0.5% ropivacaine hydrochloride.ResultsThe incidence of epidural spread after lumbar plexus block was significantly lower in the beach chair group than that in the control group [1 case (3.3%) vs. 9 (30.0%), P = 0.006]. Moreover, the imaging time (34.2 ± 16.7 s vs. 48.9 ± 16.8 s, P = 0.001), needling time (85.0 ± 45.3 s vs. 131.4 ± 88.2 s, P = 0.013) and number of needle punctures (2.7 ± 1.3 vs. 4.5 ± 2.1, P = 0.000) were significantly lower in the beach chair group than those in the control group; the ultrasound visibility score of the beach chair group was better than that of the control group. There were no significant differences in the remaining indicators.ConclusionsThe beach chair method was easier and was associated with a lower incidence of epidural spread than the control method. Therefore, the beach chair method (at the plane of the transverse process) provides another promising option for lumbar plexus block for the non-obese population.Trial registrationChinese Clinical Trial Registry (ChiCTR), Registration number:ChiCTR-INR-15007505, registered on November 06, 2015.

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Section: Discussionmentioning

confidence: 99%

Comparison of lumbar plexus block using the short axis in-plane method at the plane of the transverse process and at the articular process: a randomized controlled trial

et al. 2018

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“…However, the anatomy of sacrum in which the dorsal sacral foramen is located differs between sex, ethnicities, and heights. [6] The dorsal S1 foramen is about the same height of PSIS in upper and lower parts, from 40 to 60% of the predicted area of the midline, and in between the PSIS in medial and lateral parts, and closer to the center in caudal parts. [7] The dorsal S1 foramen is located 1 cm centrally and 1 cm caudally.…”

Section: Discussionmentioning

confidence: 99%

Relationship between first dorsal sacral foramen and lumbar facet joint connecting line in South Korea populations

et al. 2017

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The first sacral nerve root block (S1 nerve root block) is a practical procedure for patients with radiating lower back pain. In general, S1 nerve root block is performed under x-ray fluoroscopy. It is necessary to adjust the position of the patient and angle of fluoroscopy to properly visualize the first dorsal sacral foramen (dorsal S1 foramen). The purpose of this study was to analyze the location of dorsal S1 foramen and lumbar facet joint in S1 nerve root block.A total of 388 patients undergoing x-ray fluoroscopy–guided S1 nerve root block in the prone position were examined. X-ray fluoroscopy was fixed at the corresponding location of facet joint of L4–5 and L5-S1. The relationship of the connecting line vertical to L5-S1 facet joint and upper margin sacrum was evaluated. The surface anatomical relationships between dorsal S1 foramen and lumbar facet joint were assessed.Based on the localization of dorsal S1 foramen, the line drawn from point to upper margin sacrum passed through the dorsal S1 foramen in all cases. The horizontal distance from the spinous process to the dorsal S1 foramen was 25.9 ± 3.0 mm for men and 26.2 ± 1.4 mm for women. The horizontal distance from the between posterior superioriliac spine to the dorsal S1 foramen was 26.2 ± 2.7 mm for men and 26.8 ± 1.7 mm for women. The vertical distance from the upper margin of sacrum to dorsal S1 foramen to the dorsal S1 foramen was 45.6 ± 6.5 mm for men and 43.8 ± 6.0 mm for women.The connecting line vertical to L5-S1 facet joint and upper margin sacrum is located on the same line from the dorsal S1 foramen. For difficult cases of locating dorsal S1 foramen, the lumbar facet joint can assist in predicting the vertical location of the dorsal S1 foramen.

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“…The ligaments are fascial condensations with ligamentous features and are not always present at all levels or on both sides of the spine. The overall incidence of the transforaminal ligaments is approximately 47%, and the ligaments occupy as much as 30% of the foramen [6].…”

Section: Main Bodymentioning

confidence: 99%

Lumbar foraminal neuropathy: an update on non-surgical management

Choi

2019

Korean J Pain

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Lumbar foraminal pathology causing entrapment of neurovascular contents and radicular symptoms are commonly associated with foraminal stenosis. Foraminal neuropathy can also be derived from inflammation of the neighboring lateral recess or extraforaminal spaces. Conservative and interventional therapies have been used for the treatment of foraminal inflammation, fibrotic adhesion, and pain. This update reviews the anatomy, pathophysiology, clinical presentation, diagnosis, and current treatment options of foraminal neuropathy.

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Ligament, nerve, and blood vessel anatomy of the lateral zone of the lumbar intervertebral foramina

Cited by 23 publications

References 20 publications

Comparison of lumbar plexus block using the short axis in-plane method at the plane of the transverse process and at the articular process: a randomized controlled trial

Comparison of lumbar plexus block using the short axis in-plane method at the plane of the transverse process and at the articular process: a randomized controlled trial

Relationship between first dorsal sacral foramen and lumbar facet joint connecting line in South Korea populations

Lumbar foraminal neuropathy: an update on non-surgical management

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