Author devised a 3.5 cm out for L4-5, 3.5 cm down from there, for L5-S1 – 2 mm down for each model for injections. Injected 60 mg Depomedrol each level needed for radiculopathy. Got excellent results without image intensifier in 100 cases though 18 needed another shot in 3 weeks and 11 had recurrences despite that.
Comparison of Paravertebral Block of Patients of Backache with Radiculopathy, With and Without Image Intensifier
Naghmi Shirin, B. Saleem
IASP Poster Montreal 2010
Technique:
- L4-5 found by level of ilac crests
- Go 3.5 cm lateral of upper tip spinous process of L4 for L4-5 nerve root and drop down 3.5 cm from that for L5-S1 nerve root
- using a 23G spinal needle, paresthesias hit in 65/100 cases; in 35 cases had to go down 2 mm – most often subcutaneously.
- 60 mg Kenalog at each level done
- 89/100 good results though 18 had a second block in 3 weeks
- Found no advantage to use of image intensifier
Comment – where I live, I am not allowed to use local around the spine. Elsewhere, this looks like a simple and easy fix for lumbar radiculopathy.
Any comments? – surprising success for a non-transforaminal situation…
http://www.enchilame.com/user.php?login=noelchavez&view=history Thanks for that awesome posting. It saved MUCH time :-)