flouro images of lumbar spine injections
Download
Skip this Video
Download Presentation
Flouro Images of Lumbar Spine Injections

Loading in 2 Seconds...

play fullscreen
1 / 15

Flouro Images of Lumbar Spine Injections - PowerPoint PPT Presentation


  • 132 Views
  • Uploaded on

Flouro Images of Lumbar Spine Injections. David F. Drake, MD Director, VCU PM&R Pain Fellowship David Berkower, MD 2003-4 Pain Fellow. Using Contrast Dye. The following views were obtained using an injection dummy and therefore no contrast dye was used.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Flouro Images of Lumbar Spine Injections' - ilori


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
flouro images of lumbar spine injections

Flouro Images of Lumbar Spine Injections

David F. Drake, MD

Director, VCU PM&R Pain Fellowship

David Berkower, MD

2003-4 Pain Fellow

using contrast dye
Using Contrast Dye
  • The following views were obtained using an injection dummy and therefore no contrast dye was used.
  • We recommend, when available, the use of contract dye to confirm needle placement
lumbar median branch block mbb
Lumbar Median Branch Block (MBB)

The flouro is placed

in the oblique position

at approx 30 degrees

to view the “scotty dog”.

The needle is directed at

the eye of the “scotty

dog” and advanced until

bone is contacted.

Needle

lumbar facet injection
Lumbar Facet Injection

A lumbar facet injection would be done in a similar fashion as a MBB, however the target is the facet joint (between the ear of the lower “scotty dog” and the front foot of the upper “scotty dog”).

sacroiliac injection
Sacroiliac Injection

The flouro is placed

just off AP in order to

align the inferior poles

of the SIJ. The needle

is advanced into the

inferior poles until a

loss of resistance is

appreciated.

Needle

ap view of lateral hip injection
AP View of Lateral Hip Injection

The lateral hip approach avoids the nerves and vessels which may be encountered in the anterior approach. It’s wise to get a lateral flouro view to confirm needle placement.

ap view of anterior hip injection
AP View of Anterior Hip Injection

When performing a hip

injection from the anterior,

the artery should be palpated

at all times and gentle

negative pressure (aspiration)

in the syringe is important to

avoid intravascular injection.

oblique view of lumbar transforaminal epidural
Oblique View of Lumbar Transforaminal Epidural

Place the flouro in the oblique position (approx 30 deg). Focus the needle under the chin of the “scotty dog” [superior aspect of lateral foramen].

Needle

lateral view of lumbar transforaminal
Lateral View of Lumbar Transforaminal

Obtain a lateral view to

confirm needle is w/in

the foramen.

ap view of lumbar transforaminal
AP View of Lumbar Transforaminal

Finally, obtain an AP view

To confirm the needle is

Medial enough and w/in the

Epidural space.

*Note: for a selective spinal

nerve injection the needle

should be more lateral and

not w/in the epidural space.

oblique view of disc injection
Oblique View of Disc Injection

The flouro is placed in the

oblique position [approx

30 deg]. The needle is

advanced into the disc

space. A firm, fibrous

sensation is often felt when

entering the disc.

lateral view of disc injection
Lateral View of Disc Injection

A lateral flouro view is

obtained to confirm

needle depth.

ap view of disc injection
AP View of Disc Injection

An AP view may be obtained to assess how medial the needle is.

oblique lumbar sympathetic block
Oblique Lumbar Sympathetic Block

An oblique flouro view

[approx 30 deg] is obtained.

The needle is directed just

anterior to the L-3 vertebral body.

Needle

ad