Spinal anaesthesia after facet joint injection

Marks, Robert; Semple, A.J.

doi:10.1111/j.1365-2044.1988.tb05442.x

Cited by 37 publications

(19 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The success and validity of lumbar medial branch blocks depends on accurate technique and needle visualization because of the small volume of local anesthetic administered to ensure specificity [4]. Inaccurate positioning of the needle may result in false-positive blocks because of inadvertent spread of local anesthetic into the inter-vertebral foramen, the epidural space, or even the subarachnoid space, resulting in possible complications such as spinal anesthesia [8]. Thus, to enhance needle visibility on US-guided procedures, needle modifications such as polymer coating and tip dimpling have been made [1011].…”

Section: Discussionmentioning

confidence: 99%

“…Despite the numerous advantages of the use of US guidance, disruption of the image of the needle tip driven toward the target is a general problem, especially for unskilled users; the success and safety of US-guided procedures are highly dependent on needle visualization [67]. Lack of visualization of the needle during advancement in lumbar spine injections may contribute to inadvertent damage of other tissues, puncture of paraspinal vessels, and spinal anesthesia even with experienced operators [89]. Therefore, a number of methods have been used to enhance echogenicity to increase needle visualization during US using different technologies and designs [10111213].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Phantom Study of a New Laser-Etched Needle for Improving Visibility During Ultrasonography-Guided Lumbar Medial Branch Access With Novices

Park¹,

Cheon

Lee

2016

Ann Rehabil Med

View full text Add to dashboard Cite

ObjectiveTo compare the visibility and procedural parameters between a standard spinal needle and a new laser-etched needle (LEN) in real-time ultrasonography guided lumbar medial branch access in a phantom of the lumbosacral spine.MethodsWe conducted a prospective single-blinded observational study at a rehabilitation medicine center. A new model of LEN was manufactured with a standard 22-gauge spinal needle and a laser etching machine. Thirty-two inexperienced polyclinic medical students performed ultrasonography-guided lumbar medial branch access using both a standard spinal needle and a LEN with scanning protocol. The outcomes included needle visibility score, needle elapsed time, first-pass success rate, and number of needle sticks.ResultsThe LEN received significantly better visibility scores and shorter needle elapsed time compared to the standard spinal needle. First-pass success rate and the number of needle sticks were not significantly different between needles.ConclusionA new LEN is expected to offer better visibility and enable inexperienced users to perform an ultrasonography-guided lumbar medial branch block more quickly. However, further study of variables may be necessary for clinical application.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Phantom Study of a New Laser-Etched Needle for Improving Visibility During Ultrasonography-Guided Lumbar Medial Branch Access With Novices

Park¹,

Cheon

Lee

2016

Ann Rehabil Med

View full text Add to dashboard Cite

show abstract

“…Complications of intraarticular injections are rare but can be serious. Complications include infection, intraarterial or intravenous injection, spinal anesthesia, chemical meningitis, neural trauma, spinal cord injury, dural puncture, pneumothorax, radiation exposure, facet capsule rupture, hematoma formation, and steroid side effects (53,57,(63)(64)(65)(169)(170)(171)(172)(173)(174)(175)(176)(177)(178)(179)(180).…”

Section: Safety and Complicationsmentioning

confidence: 99%

Comprehensive Review of Therapeutic Interventions in Managing Chronic Spinal Pain

et al. 2009

View full text Add to dashboard Cite

Background: Available evidence documents a wide degree of variance in the definition and practice of interventional pain management. Objective: To provide evidence-based clinical practice guidelines for interventional techniques in the treatment of chronic spinal pain. Design: Best evidence synthesis. Methods: Strength of evidence was assessed by the U.S. Preventive Services Task Force (USPSTF) criteria utilizing 5 levels of evidence ranging from Level I to III with 3 subcategories in Level II. Outcomes: Short-term pain relief was defined as relief lasting 6 months or less and long-term relief as longer than 6 months, except ≤ one year and > one year for intradiscal therapies, mechanical disc decompression, spinal cord stimulation, and intrathecal infusion systems. Results: The indicated evidence for therapeutic interventions is Level I for caudal epidural steroid injections in managing disc herniation or radiculitis, and discogenic pain without disc herniation or radiculitis. The evidence is Level I to II-1 for percutaneous adhesiolysis in management of pain secondary to post-lumbar surgery syndrome. The evidence is Level II-1 or II-2 for therapeutic cervical, thoracic, and lumbar facet joint nerve blocks; for caudal epidural injections in managing pain of post-lumbar surgery syndrome, and lumbar spinal stenosis, for cervical interlaminar epidural injections in managing cervical pain (Level II-1); for lumbar transforaminal epidural injections; and spinal cord stimulation for post-lumbar surgery syndrome. Limitations: The limitations of this guideline preparation included a paucity of literature, lack of updates, and lack of conflicts in preparation of systematic reviews and guidelines by various organizations. Conclusion: The indicated evidence for therapeutic interventions is variable from Level I to III. This comprehensive review includes the evaluation of evidence for therapeutic procedures in managing chronic spinal pain and recommendations. However, this review and recommendations do not constitute inflexible treatment recommendations or “standard of care.” Key words: Interventional techniques, chronic spinal pain, therapeutic interventions, facet joint interventions, epidural procedures, epidural adhesiolysis, radiofrequency, mechanical disc decompression, spinal cord stimulation, intrathecal implantable systems

show abstract

“…The highest specificity was reached with MRI or CT guidance [35] , however, effort and costs lead to a preference of fluorescent imaging [50] . The risk of FJB is generally low, although there are case reports on infections [45] , [54] , [55] , [56] , [57] , [58] , [59] , [60] .…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Lumbar Facet Joint Injection: A Prospective Triple Cross-Over Study

et al. 2011

View full text Add to dashboard Cite

The diagnosis “lumbar facet syndrome” is common and often indicates severe lumbar spine surgery procedures. It is doubtful whether a painful facet joint (FJ) can be identified by a single FJ block. The aim of this study was to clarify the validity of a single and placebo controlled bilateral FJ blocks using local anesthetics. A prospective single blinded triple cross-over study was performed. 60 patients (31 f, 29 m, mean age 53.2 yrs (22–73)) with chronic low back pain (mean pain persistance 31 months, 6 months of conservative treatment without success) admitted to a local orthopaedic department for surgical or conservative therapy of chronic LBP, were included in the study. Effect on pain reduction (10 point rating scale) was measured. The 60 subjects were divided into six groups with three defined sequences of fluoroscopically guided bilateral monosegmental lumbar FJ test injections in “oblique needle” technique: verum-(local anaesthetic-), placebo-(sodium chloride-) and sham-injection. Carry-over and periodic effects were evaluated and a descriptive and statistical analysis regarding the effectiveness, difference and equality of the FJ injections and the different responses was performed. The results show a high rate of non-response, which documents the lack of reliable and valid predictors for a positive response towards FJ blocks. There was a high rate of placebo reactions noted, including subjects who previously or later reacted positively to verum injections. Equivalence was shown among verum vs. placebo and partly vs. sham also. With regard to test validity criteria, a single intraarticular FJ block with local anesthetics is not useful to detect the pain-responsible FJ and therefore is no valid and reliable diagostic tool to specify indication of lumbar spine surgery. Comparative FJ blocks with local anesthetics and placebo-controls have to be interpretated carefully also, because they solely give no proper diagnosis on FJ being main pain generator.

show abstract

Spinal anaesthesia after facet joint injection

Cited by 37 publications

References 0 publications

Phantom Study of a New Laser-Etched Needle for Improving Visibility During Ultrasonography-Guided Lumbar Medial Branch Access With Novices

Phantom Study of a New Laser-Etched Needle for Improving Visibility During Ultrasonography-Guided Lumbar Medial Branch Access With Novices

Comprehensive Review of Therapeutic Interventions in Managing Chronic Spinal Pain

Diagnostic Value of Lumbar Facet Joint Injection: A Prospective Triple Cross-Over Study

Contact Info

Product

Resources

About