[Lumbar CT-guided radiofrequency ablation of the medial branch of the dorsal ramus of the spinal nerve : Anatomic study and description of a new technique].
Schmerz. 2018 Apr;32(2):99-104
Authors: Feigl GC, Mattersberger C, Rosmarin W, Likar R, Avila González C
BACKGROUND: The success of radiofrequency ablation (RF) of the medial department of the dorsal ramus in sufferers with side joint ache is dependent upon the efficient coagulation distance. Up to now, computed tomography(CT)-guided methods don’t attain the nerve in parallel however reasonably than punctually. We report a new CT-guided approach to boost parallelism and proximity of the RF needle to the nerve.
MATERIALS AND METHODS: Two examiners with totally different expertise with CT-guided procedures in corpses carried out all punctures on the lumbar backbone on 10 corpses. A RF needle was inserted 1?cm lateral to the spinous means of the vertebra situated caudal to the goal nerve. The needle was superior below CT steerage at a flat angle between the superior articular course of and the bottom of the costal or transverse means of the cranial vertebra. The place was verified by dissection. Needle place was judged profitable offered the needle might be positioned within the first try with no a couple of angle correction.
RESULTS: In 86 out of 100 attainable instances (50 per facet) on the 5 lumbar segments, the RF needle might be depicted by CT within the goal space with no a couple of correction of the needle place. Anatomical dissections revealed that 47 out of 86 needles (54.6%) fulfilled the necessities of parallelism and proximity to the nerve. The dorsal ramus was by no means reached by the RF needle. Greater success charges had been obtained within the center segments in comparison with the border segments of L1-L2 and L5-S1.
CONCLUSIONS: We may reveal that the precept of parallelism and proximity of the needle to the nerve might be fulfilled with this new approach; nevertheless, needle positioning requires observe because of the indirect puncture path.
PMID: 29564634 [PubMed – in process]