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Ultrasound Lumbar Transforaminal Injection in Paramedian Sagittal Oblique Approach with Out-Plane Electrical
Jyotsna Punj1, Longjam Darendrajit Singh1, Heena Garg1
1All India Institute of Medical Science, India.
Background:
We describe a new method of ultrasound-guided lumbar transforaminal injection with an electrical stimulation needle (NsUTFI) in 2 patients with disc herniation at the L5-S1 and L4-L5 levels, respectively. The patient provided HIPAA compliant consent for the inclusion of their clinical information in this report.
Case Report:
NsUTFI was performed by eliciting sensory and/or motor stimulation of nerve roots by an electrical stimulation needle, which was inserted in an out-of-plane (OOP) trajectory just beyond the intertransverse ligament between the appropriate 2 transverse processes via a paramedian sagittal oblique (PSO) approach with a curved probe. Fluoroscopic confirmation was not done. Both patients reported 50% pain reduction at 2 weeks' follow-up.
Conclusion:
We conclude that a new technique for lumbar radicular pain with NsUTFI with a PSO OOP needle trajectory at the intertransverse ligament may be safe and effective and should be further explored.
