Specificity of Lumbar Medial Branch and L5 Dorsal Ramus Blocks

Dreyfuss, Paul; Schwarzer, Anthony C.; Lau, Peter; Bogduk, Nikolai

doi:10.1097/00007632-199704150-00013

Cited by 258 publications

(183 citation statements)

References 11 publications

Supporting

Mentioning

173

Contrasting

Unclassified

Order By: Relevance

“…The facet joint(s) may be diagnosed as the source of pain either by intra-articular injection of the facet joint(s) with local anaesthetic or by local anaesthetic block injection to the medial branches of the posterior primary rami, which are the sole sensory nerve supply from the facet joints. 10 Each joint receives innervation from two medial branches (at the level of the facet joint and the level above) and so both branches need to be blocked to diagnose facet joint pain (Figure 1,A,B). 11 The sacroiliac joint may be diagnosed similarly by intra-articular injection of local anaesthetic but as the sensory nerve supply is variable it is not feasible to diagnose through nerve blockade (Figure 1,C).…”

Section: Introductionmentioning

confidence: 99%

Audit of Conservative Management of Chronic Low Back Pain in a Secondary Care Setting – Part I: Facet Joint and Sacroiliac Joint Interventions

Chakraverty

Dias

2004

Acupunct Med

View full text Add to dashboard Cite

The work of a chronic back pain service in secondary care in the West Midlands is reported. The service offers acupuncture, spinal injection procedures, osteopathy and a range of other interventions for patients whose back pain has not responded to conservative management. This section of the report focuses on injection procedures for lumbar facet joint and sacroiliac joint pain, which have been shown to be the cause of chronic low back pain in 16–40% and 13–19% of patients respectively. Diagnosis relies on the use of intra-articular or sensory nerve block injections with local anaesthetic. Possible treatments following diagnosis include intra-articular corticosteroid, radiofrequency denervation (for facet joint pain) or ligament prolotherapy injections (for sacroiliac joint pain). The results of several hospital audits are reported. At six month follow up, 50% of 38 patients undergoing radiofrequency denervation following diagnostic blocks for facet joint pain had improved by more than 50%, compared to 29% of 34 patients treated with intra-articular corticosteroid injection. Sixty three per cent of 19 patients undergoing prolotherapy following diagnostic block injection for sacroiliac joint pain had improved at six months, compared to 33% of 33 who had intra-articular corticosteroid. Both radiofrequency denervation and sacroiliac prolotherapy showed good long-term outcomes at one year.

show abstract

Section: Introductionmentioning

confidence: 99%

Audit of Conservative Management of Chronic Low Back Pain in a Secondary Care Setting – Part I: Facet Joint and Sacroiliac Joint Interventions

Chakraverty

Dias

2004

Acupunct Med

View full text Add to dashboard Cite

show abstract

“…After identifying the target beads, to see the transverse and superior articular processes (SAP) and to obtain a view of the cross shaft became ultrasound probe to 90 degrees to show the distance from the cephalad margin of the adjacent groove side to the SAP (16), and the nearest skin surface was measured using an ultrasound caliper. Local anesthesia was performed with a 1% lidocaine injection (1 mL).…”

Section: Methodsmentioning

confidence: 99%

Ultrasound Guidance for Interventional Pain Management of Lumbar Facet Joint Pain: An Anatomical and Clinical Study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Medial branch also innervates the multifidus, interspinales, and intertransversarii mediales muscles, JORAPAIN the interspinous ligament, and, possibly, the ligamentum flavum. 4 Histological studies have shown that capsules of the facet joints are richly innervated with free nerve endings. This means that they are endowed with the appropriate sensory apparatus to transmit proprio ceptive and nociceptive information.…”

Section: Anatomymentioning

confidence: 99%

Lumbar Facet Joint Interventions

Poddar¹,

Gulati²

2017

Journal on Recent Advances in Pain

View full text Add to dashboard Cite

Facet joints or zygapophyseal joints are paired synovial joints in the vertebrae that are commonly affected by degenerative changes that cause pain and disability. It is one of the most prevalent causes of low back pain and is more commonly seen in older population. Facet joint interventions may involve an intra-articular joint injection and medial branch block. Both of them are relatively simple and straightforward procedures best performed under fluoroscopy for guidance to properly target and place the needle.

show abstract

Specificity of Lumbar Medial Branch and L5 Dorsal Ramus Blocks

Abstract: When the appropriate technique is used, medial branch blocks are target specific. To guard against false-negative responses due to intravenous up-take, contrast medium must be used before the injection of local anaesthetic.

Cited by 258 publications

References 11 publications

Audit of Conservative Management of Chronic Low Back Pain in a Secondary Care Setting – Part I: Facet Joint and Sacroiliac Joint Interventions

Audit of Conservative Management of Chronic Low Back Pain in a Secondary Care Setting – Part I: Facet Joint and Sacroiliac Joint Interventions

Ultrasound Guidance for Interventional Pain Management of Lumbar Facet Joint Pain: An Anatomical and Clinical Study

Lumbar Facet Joint Interventions

Contact Info

Product

Resources

About