Ultrasound-guided Lumbar Facet Nerve Block

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

doi:10.1097/00000542-200411000-00020

Cited by 132 publications

(34 citation statements)

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“…1D). [15,19] From the aforementioned landmark, the transducer was then moved cephalad to visualize the junction of the S1 superior articular process (SAP) with sacral ala as the anatomical target for MBBs (L5 dorsal ramus) (Fig. 1E) and the angle between the SAP and TP as the L3/4 MBBs (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…2A). [15,16,19] A long-axis paravertebral view was obtained to identify the position of the needle in the cephalad margin of the TP (Fig. 2B).…”

Section: Methodsmentioning

confidence: 99%

“…However, an ultrasound (US)-guided approach can be safe and reliable without radiation exposures and special spaces for radiation devices. [15] Recently, US-guided MBBs demonstrated high success rates, cost-effectiveness, and fewer complications than conventional methods. [15–18] …”

Section: Introductionmentioning

confidence: 99%

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Ultrasound versus fluoroscopy-guided medial branch block for the treatment of lower lumbar facet joint pain

Han

Park

Cho³

et al. 2017

Medicine

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The aim of this study was to compare the mid-term effects and benefits of ultrasound (US)-guided and fluoroscopy (FL)-guided medial branch blocks (MBBs) for chronic lower lumbar facet joint pain through pain relief, functional improvement, and injection efficiency evaluation.Patients with chronic lumbar facet joint pain who received US (n = 68) or FL-guided MBBs (n = 78) were included in this retrospective study. All procedures were performed under FL or US guidance. Complication frequency, therapeutic effects, functional improvement, and the injection efficiency of MBBs were compared at 1, 3, and 6 months after the last injection.Both the Oswestry Disability Index (ODI) and the verbal numeric pain scale (VNS) improved at 1, 3, and 6 months after the last injections in both groups. Statistical differences were not observed in ODI and VNS between the groups (P > .05). The proportion of patients who reported successful treatment outcomes showed no significant differences between the groups at different time points. Logistic regression analysis showed that sex, pain duration, injection methods, number of injections, analgesic use, and age were not independent predictors of a successful outcome. US guidance was associated with a significantly shorter performance time.US-guided MBBs did not show significant differences in analgesic effect and functional improvement compared with the FL-guided approach. Therefore, by considering our data from this retrospective study, US-guided MBBs warrant consideration in the conservative management of lower lumbar facet joint pain.

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Section: Methodsmentioning

confidence: 99%

“…2A). [15,16,19] A long-axis paravertebral view was obtained to identify the position of the needle in the cephalad margin of the TP (Fig. 2B).…”

Section: Methodsmentioning

confidence: 99%

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Ultrasound versus fluoroscopy-guided medial branch block for the treatment of lower lumbar facet joint pain

Han

Park

Cho³

et al. 2017

Medicine

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“…Recently, US-guided lumbar medial branch blocks have been demonstrated successfully except in obese patients [31820]. 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].…”

Section: Discussionmentioning

confidence: 99%

“…On the lumbosacral spine phantom, posterior paravertebral parasagittal sonograms with a long-axis view were obtained to identify the fourth lumbar vertebra by counting the transverse processes from the sacrum upward. Then, the transducer was positioned in a transverse plane to delineate the transverse processes and the superior articular processes of the adjacent facet joint [18]. After orienting the ultrasound probe toward the target point, the needle was inserted 6 cm lateral to the midline at the lateral end of the transducer and positioned in the ultrasound plane at a depth of 5 cm and an angle of approximately 45°–50° to the surface (Fig.…”

Section: Methodsmentioning

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

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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.

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