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Medial branch block

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https://www.readbyqxmd.com/read/30001215/the-response-to-radiofrequency-neurotomy-of-medial-branches-including-a-bipolar-system-for-thoracic-facet-joints
#1
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...
July 12, 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
#2
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...
December 29, 2017: 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
#3
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
#4
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
#5
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
#6
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
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...
May 30, 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
#7
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
#8
Kang-Jae Shin, Hong-San Kim, Jehoon O, Hyun-Jin Kwon, Hun-Mu Yang
INTRODUCTION: 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. METHODS & MATERIALS: The GON, lesser occipital nerve (LON) and occipital artery (OA) were carefully dissected in the occipital region of embalmed cadavers...
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
#9
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...
May 7, 2018: A&A practice
https://www.readbyqxmd.com/read/29734232/corticosteroid-injections-into-lumbar-facet-joints-a-prospective-randomized-double-blind-placebo-controlled-trial
#10
David J Kennedy, Lisa Huynh, Joe Wong, Ryan Mattie, Josh Levin, Matthew Smuck, Byron J Schneider
BACKGROUND: Corticosteroid injections into the intra-articular (IA) zygapophysial (z-joints) are frequently utilized to treat this cause of low back pain. No studies have been done on the efficacy of IA corticosteroids in those with z-joint pain confirmed by dual comparative medial branch blocks (MBB). OBJECTIVE: To determine if an injection of a corticosteroid into lumbar z-joints is effective in reducing pain and the need for radiofrequency neurotomy (RFN). DESIGN: Double-Blind, prospective, randomized, placebo controlled trial SETTING: Academic Medical Center PATIENTS: 28 subjects with z-joint pain confirmed by MBBs...
May 4, 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
#11
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
https://www.readbyqxmd.com/read/29611830/cervicogenic-dizziness-successfully-treated-with-upper-cervical-medial-branch-nerve-radiofrequency-ablation-a-case-report
#12
Xiaoying Zhu, Michael J Grover
Cervicogenic dizziness is a sensation of disequilibrium caused by abnormal afferent activity from the neck. Its diagnosis and treatment are challenging. In a case of cervicogenic dizziness, we performed diagnostic upper cervical medial branch nerve blocks with near complete symptomatic relief for around 20 hours. Radiofrequency ablation of these nerves resulted in near complete relief for 7 months. Subsequent repeat ablations provided the same relief lasting for 6-10 months. This case suggests that upper cervical medial branch block can serve as a diagnostic test for cervicogenic dizziness, and radiofrequency ablation of these nerves might be an effective treatment...
March 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29415312/novel-demonstration-of-the-anterior-femoral-cutaneous-nerves-using-ultrasound
#13
Christopher Pivec, Gerd Bodner, Johannes A Mayer, Peter C Brugger, Istvan Paraszti, Veith Moser, Hannes Traxler, Georg Riegler
PURPOSE:  Neuropathy of the intermediate (IFCN) and medial femoral cutaneous nerve (MFCN) is a potential iatrogenic complication of thigh surgery and its diagnosis is limited. This study aimed to evaluate the possibility of the visualization and diagnostic assessment of the IFCN and MFCN with high-resolution ultrasound (HRUS). MATERIALS AND METHODS:  In this study, HRUS with high-frequency probes (15 - 22MHz) was used to locate the IFCN and the MFCN in 16 fresh cadaveric lower limbs...
February 7, 2018: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/29346229/anatomical-variations-of-the-vertebral-artery-in-the-upper-cervical-spine-clinical-relevance-for-procedures-targeting-the-c1-c2-and-c2-c3-joints
#14
Maria Francisca Elgueta, Johanna Ortiz Jimenez, Nina Nan Wang, Almudena Pérez Lara, Jeffrey Chankowsky, Roshanak Charghi, De Q Tran, Roderick J Finlayson
BACKGROUND AND OBJECTIVES: Accidental breach of the vertebral artery (VA) during the performance of cervical pain blocks can result in significant morbidity. Whereas anatomical variations have been described for the foraminal (V2) segment of the VA, those involving its V3 portion (between the C2 transverse process and dura) have not been investigated and may be of importance for procedures targeting the third occipital nerve or the lateral atlantoaxial joint. METHODS: Five hundred computed tomography angiograms of the neck performed in patients older than 50 years for the management of cerebrovascular accident or cervical trauma (between January 2010 and May 2016) were retrospectively and independently reviewed by 2 neuroradiologists...
May 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29231159/facet-joint-injections-for-non-specific-low-back-pain-a-feasibility-rct
#15
Saowarat Snidvongs, Rod S Taylor, Alia Ahmad, Simon Thomson, Manohar Sharma, Angela Farr, Deborah Fitzsimmons, Stephanie Poulton, Vivek Mehta, Richard Langford
BACKGROUND: Pain of lumbar facet-joint origin is a common cause of low back pain in adults and may lead to chronic pain and disability, with associated health and socioeconomic implications. The socioeconomic burden includes an inability to return to work resulting in loss of productivity in addition to direct and indirect health-care utilisation costs. Lumbar facet-joints are paired synovial joints between the superior and inferior articular processes of consecutive lumbar vertebrae and between the fifth lumbar vertebra and the sacrum...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29216390/dose-area-product-values-of-fluoroscopically-guided-pain-management-procedures-comparison-of-a-belgian-teaching-hospital-with-national-diagnostic-reference-levels
#16
Nicolas Hustinx, Arnaud Steyaert, Bernard le Polain de Waroux, Patrice Forget
In 2011, national diagnostic reference levels (DRLs) were proposed for pain management fluoroscopic procedures in Belgium. The primary goal of this work is to compare the dose area product values (DAP) recorded at the Saint-Luc University Hospital to these DRLs. From 2012 to 2015, 7664 interventional pain management procedures (4740 epidural, 2097 medial branch and 807 transforaminal infiltrations) were performed. Uni/multivariable analyses were done regarding the influence of different factors. The fluoroscopy duration and the DAP are lower to the DRLs (p < 0...
May 1, 2018: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29205431/anatomic-delineation-of-tarsal-tunnel-innervation-via-ultrasonography
#17
Alvaro Iborra, Manuel Villanueva, Stephen L Barrett, Edgardo Rodriguez-Collazo, Pablo Sanz
OBJECTIVES: High-resolution ultrasonography (US) can play an important role in studying nerves, as it has several advantages. Entrapments of distal tibial nerve branches can be mapped out or diagnosed with selective anesthetic blocks, and US can guide therapeutic procedures, such as radiofrequency ablation and selective infiltrations of specific nerve branches. The aim of this study was to verify that US is an effective method for accurately locating the posterior tibial nerve and its terminal branches, such as the medial calcaneal branch, the first calcaneal branch, and the medial and lateral plantar nerves...
June 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29203308/magnetic-resonance-imaging-undetectable-epiduroscopic-hotspot-in-chronic-diskogenic-back-pain-does-sinuvertebral-neuropathy-actually-exist
#18
Sung Ho Choi, Nitin Adsul, Hyeun Sung Kim, Jee-Soo Jang, Il-Tae Jang, Seong-Hoon Oh
BACKGROUND: The causes of chronic diskogenic back pain have not yet been clearly identified. Neural ingrowth around the annulus is widely considered to be one of the possible cause. However, neuropathy around the annulus has yet to be observed visually. We report a case of a hotspot that was observed in an epiduroscopic view, but not in imaging findings. CASE DESCRIPTION: A 46-year-old woman was admitted with pain in the back, left buttock, and posterior thigh for 2 years...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29200944/cost-utility-analysis-of-cervical-therapeutic-medial-branch-blocks-in-managing-chronic-neck-pain
#19
Laxmaiah Manchikanti, Vidyasagar Pampati, Alan D Kaye, Joshua A Hirsch
Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29174073/lumbar-medial-branch-block-volume-dependent-dispersion-patterns-as-a-predictor-for-ablation-success-a-cadaveric-study
#20
Sayed E Wahezi, Edward Alexeev, John S Georgy, Nogah Haramati, Stephen A Erosa, Jay M Shah, Sherry Downie
BACKGROUND: Lumbar facet arthropathy is a common cause of low back pain. Literature supports treatment with radiofrequency ablation (RFA) of associated nerves that innervate lumbar facets when alternative conservative therapies have failed. Diagnostic local anesthetic blocks precede therapeutic ablation, but have a false-positive rate of 27%-63%, and some authors have questioned their utility in predicting therapeutic response to RFA. The authors of the current study believe that injectate volume may be a contributing factor to false positivity...
November 22, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
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