Ultrasound-guided lumbar facet nerve block: high accuracy of a new technique confirmed by CT-scan control

Greher, Manfred; Kirchmair, Lukas; Enna, Birgit; Kovács, Péter; Gustorff, Burkhard; Kapral, Stephan; Moriggl, Bernhard

doi:10.1097/00003643-200406002-00408

Cited by 40 publications

(53 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The study was performed according to the ethical guidelines of the Swiss Academy of Medical Sciences for investigations using human cadavers [21]. The cadavers were embalmed using Thiel's method [22], which renders cadaveric tissue similar in texture to that of live humans, enabling sonographic studies to be performed [18,23,24].…”

Section: Methodsmentioning

confidence: 99%

Placement of coiled catheters into the paravertebral space*

et al. 2012

View full text Add to dashboard Cite

SummaryThere are conflicting results with regard to the use of catheter-based techniques for continuous paravertebral block. Local anaesthetic spread within the paravertebral space is limited and the clinical effect is often variable. Discrepancies between needle tip position and final catheter position can also be problematic. The aim of this proof-of-concept study was to assess the reliability of placing a newly developed coiled catheter in human cadavers. Sixty Tuohy needles and coiled catheters were placed under ultrasound guidance, three on each side of the thoracic vertebral column in 10 human cadavers. Computed tomography was used to assess needle tip and catheter tip locations. No catheter was misplaced into the epidural, pleural or prevertebral spaces. The mean (SD) distance between catheter tips and needle tips was 8.2 (4.9) mm. The median (IQR [range]) caudo-cephalad spread of contrast dye injectate through a subset of 20 catheters was 4 (4-5[3-8]) thoracic segments. All catheters were removed without incident. Precise paravertebral catheter placement can be achieved using ultrasound-guided placement of a coiled catheter.

show abstract

Section: Methodsmentioning

confidence: 99%

Placement of coiled catheters into the paravertebral space*

et al. 2012

View full text Add to dashboard Cite

show abstract

“…[30] In another study, US guided lumbar medial branch blockade application was controlled with fluoroscopy and in 96 out of 101 cases the needle was in correct position and in 2 cases intravascular injection was observed. [31] Lumbar Medial branch blockade with US guidance may be difficult in the presence of degenerative changes in vertebrae and if patient's body mass index (BMI) is high.…”

Section: Lumbar Medial Branch Blockadementioning

confidence: 99%

Ultrasound guided chronic pain interventions (Part II)

AKKAYA¹

2016

Agri

View full text Add to dashboard Cite

SummaryHenceforth, ultrasonography (US) is an indispensible imaging technique in regional anesthesia practice. With the guidance of US, various invasive interventions in chronic pain pathologies of the musculoskeletal system, peripheral and neuroaxial pathologies has become possible. The management includes diagnostic blocks as weel as radiofrequency ablation and institution of neurolythic agents. During these algologic interventions we are able to see the target tissue, the dispersion of the drug and all nearby vascular structures. Besides these the US also protects the team from ionic radiation that one encounters when using flouroscopy of computed tomography. Latest publication in this field show that applicability of US in chronic pain syndromes is rapidly expanding with a good future. The additional equipment (echogenic needles, 3-D US etc.) will also expands its applications in algology practice. This review highlights different applications of US in chronic pain conditions.

show abstract

“…With the clear evidence of the reliable role of US guidance in increasing the efficacy and safety of diagnostic and therapeutic peripheral nerve blocks and spinal anesthesia [9][10][11][12], there has been a growing interest in the use of US guidance with interventional spinal procedures. Although fluoroscopy remains the most frequently used imaging technique employed by interventional spine physicians [13,14 •• ], reports of the use of US guidance have begun to emerge [15][16][17][18]. Thus, it is timely to review the scientific and clinical value of US guidance in the most commonly utilized procedures of the spine.…”

Section: Emergence Of Ultrasound Guidancementioning

confidence: 99%

“…Beginning in 2004, the reports of US guidance in facet procedures in the cervical [31, 47, 50, 65 • , 66-69] and lumbar spine [18,32,70] were described in the literature. Comprehensive review of the literature shows a higher number of quality studies evaluating the role of US in lumbar facetrelated procedures (Table 1).…”

Section: Ultrasound Guided Lumbar Facet Injectionsmentioning

confidence: 99%

“…Direct visualization of the facet nerve at a 5 cm depth using US guidance was unable to be performed but using their method based on a sonographic cross-axis and long-axis view, the authors were able to set the needle target point for a lumbar medial branch nerve block demonstrating that 25 of 28 US-guided needles in five patients were correctly positioned and that injection of 1 ml solution results in a remarkable spread around the needle tip as confirmed on fluoroscopy. In a follow-up study, Greher et al [18] tested the accuracy of their US-guided technique for fifty bilateral lumbar medial branch nerve blocks with a CT imaging study. Using the target point of the groove at the cephalad margin of the transverse process adjacent to the superior articular process, the authors found 45 of the 50 needle tips at L1-L5 located at the exact target point and in 47 of 50 cases, the applied contrast dye reached the groove where the nerve is located, corresponding to a simulated block success rate of 94 %.…”

Section: Ultrasound Guided Lumbar Facet Injectionsmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound Guided Spine Injections: Advancement Over Fluoroscopic Guidance?

Yoon

O’Brien

Tran

2013

Curr Phys Med Rehabil Rep

View full text Add to dashboard Cite

This review article discusses the current role of ultrasound in interventional spine practice as both a diagnostic tool and as a modality for image guidance with procedures. Epidemiology of spine pain, the emergence of ultrasound, advantages and disadvantages of ultrasound in comparison to other image modalities are discussed. Recent selected published articles pertaining to the role of ultrasound in the guidance of spinal interventional procedures are reviewed. The potential for the use of ultrasound with spine procedures is discussed as well as further evaluation of its cost-effectiveness, accuracy, safety, and efficacy when compared to the current standards of practice.

show abstract

Ultrasound-guided lumbar facet nerve block: high accuracy of a new technique confirmed by CT-scan control

Cited by 40 publications

References 1 publication

Placement of coiled catheters into the paravertebral space*

Placement of coiled catheters into the paravertebral space*

Ultrasound guided chronic pain interventions (Part II)

Ultrasound Guided Spine Injections: Advancement Over Fluoroscopic Guidance?

Contact Info

Product

Resources

About