Angled posteroanterior fluoroscopy for L5-S1 discography: a technical note

Area of Science:

• Radiology
• Orthopedics
• Pain Management

Background:

• Lumbar discography is a key diagnostic tool for lower back pain.
• Accurate L5-S1 disc space needle placement can be challenging, particularly with degenerative changes.
• Current fluoroscopic views may not always provide optimal visualization.

Purpose of the Study:

• To describe a novel radiographic technique using angled posteroanterior fluoroscopy for improved L5-S1 disc visualization.
• To enhance the accuracy of needle placement during lumbar discography.

Main Methods:

• A prone patient positioning with a 30-40 degree caudal angulation of the fluoroscopy beam was utilized.
• This technique specifically targets clear visualization of the L5-S1 disc space.
• Fluoroscopy was used for guidance during needle insertion.

Main Results:

• The described angled fluoroscopic view facilitates clear visualization of the L5-S1 disc.
• This method aids in achieving accurate needle placement within the target disc space.
• Potential benefits include reduced procedure time and decreased fluoroscopic radiation exposure.

Conclusions:

• Angled posteroanterior fluoroscopy is an effective technique for lumbar discography.
• This approach can improve procedural efficiency and patient safety by optimizing needle placement and reducing radiation.
• It offers a valuable modification for lumbar discography, especially in challenging cases.