The concept of blocking spinal nerves is validated by relieving the pain transmitted by that nerve. Similarly, blocking a painful structure (e.g., inflamed joint) should provide at least temporal alleviation of pain. Diagnostic and therapeutic lumbar zygapophysial (facet) nerve and joint interventions are among the most commonly performed injections in pain management. Traditionally, fluoroscopic guidance is required to ensure precise needle positioning and to exclude intravascular injection. Since the procedure is considered to be a low-risk intervention, utilization of ultrasound guidance is thought to be an attractive alternative to fluoroscopy mainly because it renders no ionizing radiation to the patient and medical personnel and helps identify soft tissue targets. In addition, ultrasound-guided procedures are essentially “office-based” and do not require a radiology suite or operating room.
Facet Joint Transverse Process Lumbar Lordosis Ligamentum Flavum Medial Branch
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