Ultrasound and nerve stimulation-guided L5 nerve root block.

Abstract:

STUDY DESIGN:Case series. OBJECTIVE:Evaluation of ultrasound and nerve stimulation-guided L5 nerve root block technique. SUMMARY OF BACKGROUND DATA:Ultrasound-guided peripheral nerve block has become clinically applied. However, selective lumbosacral nerve root block is conducted under radiographic guidance, which involves patients and operators being exposed to radiation. In addition, it cannot be carried out easily during outpatient visits or at the bedside. We conducted L5 nerve root block, which is one of the most common lumbosacral nerve root block under ultrasonic guidance, using electrical nerve stimulation. METHODS:We assessed the effectiveness of ultrasound and nerve stimulation-guided L5 nerve root block on 78 patients with L5 radicular syndrome. To compare ultrasonic guidance using electrical nerve stimulation with radiographic guidance, we used a contrast agent and assessed its distribution. RESULTS:After nerve block, decreased sensation at L5 neural region and diminished/fully resolved pain was observed in all patients except for 3 in whom nerve block could not be conducted as their articular process protruded laterally. Concerning the response to stimulation, all except for these 3 felt the tapping sensation at their L5 neural regions, but no contraction of muscles was observed. The number of patients who showed an extraneural, paraneural, and intraneural pattern on contrast radiography was 71, 4, and 0, respectively. CONCLUSION:Ultrasound-guided L5 nerve root block using electrical nerve stimulation is a safe and effective method.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Sato M,Simizu S,Kadota R,Takahasi H

doi

10.1097/BRS.0b013e3181b43c62

subject

Has Abstract

pub_date

2009-11-15 00:00:00

pages

2669-73

issue

24

eissn

0362-2436

issn

1528-1159

pii

00007632-200911150-00012

journal_volume

34

pub_type

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