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Electrical stimulation induced lumbar medial branch referral patterns
Robert E Windsor1, Frank J King, Stephen J Roman
1Emory/Georgia Pain Physicians, Pain Medicine Fellowship, Emory Physical Medicine & Rehabilitation, 2250 Windy Hill Road, Suite, 215, Marietta, GA 30067, USA. rwindsor@aol.com
Pain Physician
|August 4, 2006
Summary
Electrical stimulation of lumbar medial branches reveals distinct pain referral patterns compared to zygapophysial joint injections. These findings offer new insights for diagnosing and treating back, flank, and gluteal pain.
Area of Science:
- Pain Medicine
- Anatomy
- Neurology
Background:
- Lumbar zygapophysial (Z-joint) referral patterns are known from provocative injections.
- However, specific referral patterns for lumbar medial branches are not well-documented.
Purpose of the Study:
- To determine the pain referral patterns of the lumbar medial branches and the fifth lumbar dorsal ramus.
- To investigate if these patterns differ from those associated with Z-joint injections.
Main Methods:
- Eight healthy males underwent fluoroscopically guided electrical stimulation of lumbar medial branches (L1-L4) and the L5 dorsal ramus.
- Subjects mapped pain referral areas, which were then compiled into composite drawings.
- Stimulation thresholds and referral patterns were recorded and compared to existing Z-joint injection data.
Main Results:
- Consistent referral sites were observed across all subjects, forming a defined composite map.
- The identified referral zones differ significantly from those previously reported for lumbar Z-joint injections.
Conclusions:
- Electrical stimulation of lumbar medial branches yields distinct pain referral patterns.
- These findings have potential clinical implications for evaluating and treating patients with lumbar, flank, or gluteal pain of unclear origin.
