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Ultrasound-Guided Lumbar Medial-Branch Block: A Clinical Study With Fluoroscopy Control

Authors
 Jae-Kwang Shim  ;  Jin-Cheon Moon  ;  Kyung-Bong Yoon  ;  Won-Oak Kim  ;  Duck-Mi Yoon 
Citation
 REGIONAL ANESTHESIA AND PAIN MEDICINE, Vol.31(5) : 451-454, 2006 
Journal Title
 REGIONAL ANESTHESIA AND PAIN MEDICINE 
ISSN
 1098-7339 
Issue Date
2006
MeSH
Adult Aged Female Fluoroscopy Humans Low Back Pain/therapy* Lumbar Vertebrae/diagnostic imaging* Male Middle Aged Nerve Block/methods* Ultrasonography Zygapophyseal Joint*
Abstract
BACKGROUND AND OBJECTIVES: For diagnostic lumbar medial-branch blocks, fluoroscopic guidance is considered mandatory, but this technique comes with radiation exposure. The clinical feasibility of the ultrasound-guided lumbar medial-branch block has been demonstrated. We evaluated the success rate and validity of this new method by use of fluoroscopy controls in patients previously diagnosed with lumbar facet joint-mediated pain. METHODS: In 20 patients, 101 lumbar medial-branch blocks were performed under ultrasound guidance. The target point was the groove at the cephalad margin of the transverse process adjacent to the superior articular process. C-arm fluoroscopy was performed afterward to confirm the needle position. Pain scores were assessed by use of visual analog scale (VAS 0 to 100). RESULTS: All 101 needles were placed in the correct lumbar segment. Ninety-six of the 101 needletips were in the correct position with a success rate of 95%. Two needles were associated with intravascular spread of the contrast dye. VAS score was reduced from 52 to 16 after the block. CONCLUSIONS: Ultrasound-guided lumbar medial-branch blocks can be performed with a high success rate. However, to be completely independent from fluoroscopy controls, this technique requires further studies regarding the detection of intravascular spread.
Full Text
http://www.sciencedirect.com/science/article/pii/S1098733906004196
DOI
10.1016/j.rapm.2006.06.246
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Oak(김원옥)
Yoon, Kyoung Bong(윤경봉) ORCID logo https://orcid.org/0000-0002-4167-1375
Yoon, Duck Mi(윤덕미)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/110907
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