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Medial branch block

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https://www.readbyqxmd.com/read/30399625/inter-rater-reliability-of-pain-provocation-tests-for-painful-lumbar-facet-joints-a-pilot-study
#1
Christoph Thalhamer, Julia Hahne, Omer Matthijs, Peter Machacek
BACKGROUND: With a life-time prevalence of 39%, low back pain (LBP) is one of the most common musculoskeletal disorders. Correct diagnosis of underlying causes is commonly seen as a prerequisite for successful therapy of LBP. Currently, there is no useful, non-invasive clinical test to diagnose painful lumbar zygapophyseal joints. Clinical tests with high diagnostic accuracy are therefore desirable. Inter-rater reliability is commonly seen as a prerequisite of test validity. The objective of this pilot study was thus to evaluate inter-rater reliability of new clinical pain provocation tests for diagnosing painful lumbar zygapophyseal joints...
November 6, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/30367999/cervical-medial-branch-block-volume-dependent-dispersion-patterns-as-a-predictor-for-ablation-success-a-cadaveric-study
#2
Sayed E Wahezi, Jocelin Jones Molina, Edward Alexeev, John S Georgy, Nogah Haramati, Stephen A Erosa, Jay M Shah, Sherry Downie
BACKGROUND: Neck pain is one of the most common causes of chronic pain and the fourth leading cause of disability worldwide; it is estimated that between 36% to 67% of this pain is due to facet arthropathy. For patients who have pain refractory to conservative treatments literature supports management with diagnostic cervical medial branch blocks (cMBBs) to identify the associated facet innervation as the source of pain followed by therapeutic radiofrequency ablation (RFA) of the identified nerves...
October 24, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/30365581/management-of-great-auricular-neuralgia-confirmed-by-electrophysiologic-examination-a-case-report
#3
Shin Who Park, Ja Young Choi, Kang Jae Jung
The great auricular nerve (GAN) is a sensory branch of the cervical plexus originating from the C2 and C3 nerve roots that innervates the external ear, mandibular angle, and parotid gland. Since idiopathic GAN neuralgia is a rare condition and branches of the GAN overlap with other cervical and cranial nerves, its diagnosis is challenging and can be confused with other facial neuralgias. This article describes the case of a 55-year-old woman with intractable unilateral periauricular and lateral head pain. No significant findings were found on cervical and brain imaging...
October 2018: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/30282393/comparison-of-efficacy-of-lateral-branch-pulsed-radiofrequency-denervation-and-intraarticular-depot-methylprednisolone-injection-for-sacroiliac-joint-pain
#4
Kaustuv Dutta, Samarjit Dey, Prithwis Bhattacharyya, Sharat Agarwal, Priyanka Dev
BACKGROUND: Sacroiliac joint dysfunctional pain has always been an enigma to the pain physician, whether it be the diagnosis or the treatment. Diagnostic blocks are the gold standard way to diagnose this condition. Radiofrequency neurotomy of the nerves supplying the sacroiliac joint has shown equivocal results due to anatomical variation. Intraarticular depo-steroid injection is a traditional approach to treating sacroiliac joint pain. For long-term pain relief, however, lesioning the sacral lateral branches may be a better approach...
September 2018: Pain Physician
https://www.readbyqxmd.com/read/30276418/ultrasound-guided-intermediate-cervical-plexus-and-additional-peripheral-facial-nerve-block-for-carotid-endarterectomy-a-prospective-pilot-study
#5
R Seidel, K Zukowski, A Wree, M Schulze
BACKGROUND AND OBJECTIVES: Ultrasound-guided intermediate cervical plexus block with perivascular local anesthetic infiltration is an established anesthetic procedure for carotid endarterectomy. In this prospective pilot study an additional subplatysmal block of the superficial ansa cervicalis is presented for the first time. The target structures are the anastomoses between the facial nerve (cervical and marginal mandibular branches) and cervical plexus. METHODS: An ultrasound-guided intermediate cervical plexus block (20 ml of ropivacaine 0...
October 1, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/30236251/ultrasound-guided-adductor-canal-block-a-cadaver-study-investigating-the-effect-of-a-thigh-tourniquet
#6
A Nair, J Dolan, K E Tanner, C M Kerr, B Jones, P J Pollock, C F Kellett
BACKGROUND: Placement of local anaesthetic within the adductor canal using ultrasonography is an alternative to femoral nerve blocks for postoperative pain relief after knee joint replacement surgery. However, the effect of an inflated thigh tourniquet on the distribution of local anaesthetic within the adductor canal is unknown. The aim of this cadaveric study was to compare the distribution of radio-opaque dye within the adductor canal in the presence or absence of an inflated thigh tourniquet...
October 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/30169476/rhomboid-intercostal-and-subserratus-plane-block-a-cadaveric-and-clinical-evaluation
#7
Hesham Elsharkawy, Robert Maniker, Robert Bolash, Prathima Kalasbail, Richard L Drake, Nabil Elkassabany
BACKGROUND AND OBJECTIVES: Fascial plane blocks are rapidly emerging to provide safe, feasible alternatives to epidural analgesia for thoracic and abdominal pain. We define a new option for chest wall and upper abdominal analgesia, termed the rhomboid intercostal and subserratus plane (RISS) block. The RISS tissue plane extends deep to the erector spinae muscle medially and deep to the serratus anterior muscle laterally. We describe a 2-part proof-of-concept study to validate the RISS block, including a cadaveric study to evaluate injectate spread and a retrospective case series to assess dermatomal coverage and analgesic efficacy...
August 30, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/30167824/re-defining-the-anatomical-structures-for-blocking-the-nerves-in-adductor-canal-and-sciatic-nerve-through-the-same-injection-site-an-anatomical-study
#8
S Kendir, Bilge İpek Torun, T Akkaya, A Comert, E Tuccar, I Tekdemir
PURPOSE: The aim of this study is to re-define the anatomical structures which are important for blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site. We also aimed to investigate the spread of the anesthetic toward the areas in which the mentioned nerves lie on cadavers. METHODS: This study was performed on 16 lower extremities of formaldehyde-embalmed eight adult cadavers. The anatomy of adductor canal, courses of the nerves within the canal and the relationships of the saphenous, medial femoral cutaneous, medial retinacular, posterior branch of the obturator and sciatic nerves with each other and with the fascial compartments were investigated...
November 2018: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/30095696/pectoral-block-failure-may-be-due-to-incomplete-coverage-of-anatomical-targets-a-dissection-study
#9
Lena F Carstensen, Morten Jenstrup, Jørgen Lund, Jørgen Tranum-Jensen
BACKGROUND AND OBJECTIVES: The popularization of ultrasound-guided nerve blocks in cosmetic and reconstructive breast surgery calls for better anatomical understanding of chest wall innervation. When inserting subpectoral implants, pain from pocket dissection, stretching of muscle, and release of costal attachments may be relieved by blocking the pectoral nerves in the interpectoral (IP) space.We describe the variable anatomy of the pectoral nerves in the IP space in order to define the area to be covered for sufficient blockade, based on cadaver dissections...
November 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/30001215/the-response-to-radiofrequency-neurotomy-of-medial-branches-including-a-bipolar-system-for-thoracic-facet-joints
#10
Olav Rohof, Chee Kean Chen
Background and aims The evidence for interventional treatment of thoracic facet joint pain remains limited. This is partly due to inconsistency of the path of thoracic medial branches and a lower incidence of thoracic facet pain among spine pain patients. The purpose of this study is to evaluate the efficacy of bipolar radiofrequency (RF) neurotomy of medial branches for treating chronic thoracic facet joint pain. Methods This is a retrospective record review of all patients diagnosed to have thoracic facet pain with diagnostic block and subsequently treated with bipolar RF neurotomy of medial branch between January 2012 and December 2015...
October 25, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913870/treatment-of-post-traumatic-pain-and-autonomic-and-muscular-dysfunction-by-ganglion-impar-block-and-medial-branch-block-of-the-facet-joints-a-case-report
#11
Johan Hambræus, Hans Westergren
Introduction Patients exposed to whiplash trauma are at risk of developing pain and dysfunction of the neck and shoulder. Although rarely discussed in the literature, some patients also develop autonomic dysfunction. Case presentation A previously healthy 41-year-old woman was involved in a "head-on" car crash. During the following 3 years she developed severe and complex post-traumatic pain syndrome, which consisted of neck pain, lumbar pain, sensory-motor dysfunction, and myoclonic muscular contractions...
October 1, 2012: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29887291/radiological-study-to-evaluate-the-spreading-of-two-volumes-10-vs-20ml-of-radiological-contrast-in-the-block-of-cutaneous-branches-of-intercostal-nerves-in-medial-axillary-line-brilma-in-a-porcine-experimental-model
#12
O Varela, A Melone, R López-Menchaca, R Sevilla, D Callejo, S López-Álvarez, A Román Fernández, S García, I Mantilla, M Zaballos
OBJECTIVE: Interfascial blocks of the thoracic wall are being developed as an alternative to central blocks in breast surgery. However, there are few studies that have evaluated the anatomical extension of the local anaesthetic. The objective of this study was to analyse, using fluoroscopy, the spreading of two volumes (10 vs. 20ml) of radiological contrast in the serratus-intercostal plane block in an experimental pig model. MATERIAL AND METHODS: Ten Large-White breed pigs were selected to have a bilateral ultrasound serratus-intercostal plane block performed, with the administering of 10ml and 20ml of iopamidol in the right and left hemithorax, respectively...
June 7, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29871375/improving-fluoroscopic-visualization-for-lower-cervical-medial-branch-blocks-with-a-modified-swimmer-s-view-a-technical-report
#13
David S Stolzenberg, Ryan Pheifer, Joshua Armstrong, George Young, Jeffrey Gehret, Jeremy Simon, George C Chang-Chien
BACKGROUND: Neural blockade of the cervical medial branches is a validated procedure in the diagnosis and treatment of cervical zygapophyseal joint pain. Fluoroscopic visualization of the lower cervical medial branch target zones (CMBTZs) in lateral view is sometimes challenging or not possible due to the patient's shoulders obscuring the target. Large shoulders and short necks often exacerbate the problem. Clear visualization is critical to accuracy and safety. OBJECTIVE: We aim to describe a method for optimal fluoroscopic visualization of the lower CMBTZs using a modified swimmer's view...
May 2018: Pain Physician
https://www.readbyqxmd.com/read/29871373/response-to-cervical-medial-branch-blocks-in-patients-with-cervicogenic-vertigo
#14
Tim Hahn, Marc-Eric Halatsch, Christian Wirtz, Stephan Klessinger
BACKGROUND: Among the various causes of vertigo, the so-called cervicogenic vertigo (CV) has been the most controversial. However, perturbations of proprioceptive signals and abnormal activity of the cervical afferents can induce vertigo. Medial branch blocks (MBBs) are a diagnostic tool designed to test whether a patient's neck pain is mediated by one or more of the medial branches of the dorsal rami of the spinal nerve. It is unknown whether MBBs are also suitable for testing symptoms other than pain...
May 2018: Pain Physician
https://www.readbyqxmd.com/read/29847426/effectiveness-of-lumbar-facet-joint-blocks-and-predictive-value-before-radiofrequency-denervation-the-facet-treatment-study-facts-a-randomized-controlled-clinical-trial
#15
Steven P Cohen, Tina L Doshi, Octav C Constantinescu, Zirong Zhao, Connie Kurihara, Thomas M Larkin, Scott R Griffith, Michael B Jacobs, William J Kroski, Timothy C Dawson, Ian M Fowler, Ronald L White, Aubrey J Verdun, David E Jamison, Mirinda Anderson-White, Stephanie E Shank, Paul F Pasquina
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: With facet interventions under scrutiny, the authors' objectives were to determine the effectiveness of different lumbar facet blocks and their ability to predict radiofrequency ablation outcomes. METHODS: A total of 229 participants were randomized in a 2:2:1 ratio to receive intraarticular facet injections with bupivacaine and steroid, medial branch blocks, or saline. Those with a positive 1-month outcome (a 2-point or more reduction in average pain score) and score higher than 3 (positive satisfaction) on a 5-point satisfaction scale were followed up to 6 months...
September 2018: Anesthesiology
https://www.readbyqxmd.com/read/29755174/clinical-diagnostic-tests-versus-medial-branch-blocks-for-adults-with-persisting-cervical-zygapophyseal-joint-pain-a-systematic-review-and-meta-analysis
#16
Kendra Usunier, Mark Hynes, James Michael Schuster, Annie Cornelio-Jin Suen, Jackie Sadi, David Walton
Purpose: A systematic review and meta-analysis were performed to identify clinical tests for diagnosing cervical zygapophyseal joint pain (CZP) and to determine their diagnostic accuracy. Method: A search strategy was carried out to find relevant evidence published in CINAHL, Embase, MEDLINE, and PEDro from 1980 to January 1, 2015, pertaining to the clinical diagnosis of CZP. Quality assessment was completed using the Quality Assessment of Diagnostic Accuracy Studies-2. Results were analyzed to pool sensitivity and specificity and clarify diagnostic value...
2018: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/29752841/anatomical-consideration-of-the-occipital-cutaneous-nerves-and-artery-for-the-safe-treatment-of-occipital-neuralgia
#17
Kang-Jae Shin, Hong-San Kim, Jehoon O, Hyun-Jin Kwon, Hun-Mu Yang
There is no standardized approach to the greater occipital nerve (GON) block technique for treating occipital neuralgia. The aim of the present study was to validate the previously-suggested guidelines for conventional injection techniques and to provide navigational guidelines for safe GON block. The GON, lesser occipital nerve (LON) and occipital artery (OA) were carefully dissected in the occipital region of embalmed cadavers. Using a 3 D digitizer, the GON, LON, and OA were observed on the two reference lines...
May 12, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29738329/transthoracic-arteriovenous-graft-repair-with-the-pectoralis-pecs-ii-nerve-block-for-primary-intraoperative-anesthesia-and-postoperative-analgesia-a-case-report
#18
Gabriel Farkas, Garret Weber, Jonathon Miller, Jeff Xu
The PECS II nerve block is a relatively new regional anesthetic technique that targets the medial and lateral pectoral nerves, as well as the lateral cutaneous branches of the intercostal nerves. It has been described for surgical cases involving the breast, as an adjunct or alternative to neuraxial or paravertebral techniques. This case report describes the first successful use of the PECS II nerve block placed using ultrasound guidance as the primary anesthetic and postoperative analgesic in a non-breast-related chest wall surgery...
October 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29734232/corticosteroid-injections-into-lumbar-facet-joints-a-prospective-randomized-double-blind-placebo-controlled-trial
#19
David J Kennedy, Lisa Huynh, Joe Wong, Ryan Mattie, Josh Levin, Matthew Smuck, Byron J Schneider
BACKGROUND: Corticosteroid injections into the intra-articular zygapophysial (z-joints) are frequently used to treat this cause of low back pain. No studies have been done on the efficacy of intra-articular corticosteroids in those with z-joint pain confirmed by dual comparative medial branch blocks. OBJECTIVE: The aim of the study was to determine whether an injection of a corticosteroid into lumbar z-joints is effective in reducing pain and the need for radiofrequency neurotomy...
October 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29708263/parameters-and-functional-analysis-of-the-deep-epaxial-muscles-in-the-thoracic-lumbar-and-sacral-regions-of-the-equine-spine
#20
J A García Liñeiro, G H Graziotti, J M Rodríguez Menéndez, C M Ríos, N O Affricano, C L Victorica
The epaxial muscles produce intervertebral rotation in the transverse, vertical and axial axes. These muscles also counteract the movements induced by gravitational and inertial forces and movements produced by antagonistic muscles and the intrinsic muscles of the pelvic limb. Their fascicles are innervated by the dorsal branch of the spinal nerve, which corresponds to the metamere of its cranial insertion in the spinous process. The structure allows the function of the muscles to be predicted: those with long and parallel fibres have a shortening function, whereas the muscles with short and oblique fibres have an antigravity action...
July 2018: Journal of Anatomy
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