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Lumbar discogram resulting from lumbar interlaminar epidural injection
1Anesthesiologists of Greater Orlando, Orlando, FL 32804, USA. jeffrey_j_huang@hotmail.com
Journal of Clinical Anesthesia
|July 21, 2004
Summary
An accidental lumbar discogram occurred during an epidural injection attempt. This case highlights a potential anatomical triangle at L5-S1 for alternative discography access without complications.
Area of Science:
- Neurosurgery
- Pain Management
- Radiology
Background:
- Lumbar discography is a diagnostic tool to identify intervertebral discogenic pain.
- It involves injecting contrast into the disc nucleus to visualize internal structures.
Observation:
- A case of inadvertent lumbar discogram during an attempted L5-S1 interlaminar epidural injection under fluoroscopy is described.
- The patient experienced no postdural puncture headache or nerve root irritation.
Findings:
- The "potential triangle" anatomical space at L5-S1, formed by the exiting nerve root, dura, and pedicle, may explain the needle's trajectory.
- Accurate needle placement within this triangle might allow discography without dural puncture or nerve root trauma.
Implications:
- This anatomical space could offer an alternative approach for lumbar discography at the L5-S1 level.
- Further research into this technique may refine diagnostic procedures for low back pain.