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Published on: October 17, 2025
Fluoroscopically guided lumbar facet joint injection using an interlaminar approach and loss of resistance technique
1Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA. ajhuang@mgh.harvard.edu.
Purpose:
To describe a new technique for performing fluoroscopically guided lumbar facet joint injections using an interlaminar approach and loss-of-resistance technique and to report the initial success rate of this technique in a small series of patients.
Materials And Methods:
The institutional radiology database was retrospectively reviewed to identify patients who underwent fluoroscopically guided lumbar facet joint injections. Between 1 May 2014 and 31 October 2015, one radiologist attempted fluoroscopically guided lumbar facet joint injections using an interlaminar approach and loss-of-resistance technique in ten severely osteoarthritic facet joints (4 patients). Patient demographics, facet joint side and level, and whether or not an intra-articular facet joint injection was achieved were recorded.
Results:
Intra-articular injection was achieved using the interlaminar approach and loss-of-resistance technique in five facet joints.
Conclusion:
Fluoroscopically guided lumbar facet joint injection using an interlaminar approach and loss-of-resistance technique is an alternative approach to a direct posterior facet joint injection and may be particularly useful for severely osteoarthritic facet joints, where bulky osteophytes and/or extreme curvature of the joints in the transverse plane threaten to preclude direct posterior access to the joints.
