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Abstract

1. 2022;6;125-128 Ultrasound Lumbar Transforaminal Injection in Paramedian Sagittal Oblique Approach with Out-Plane Electrical Stimulation Needle: Case Report of 2 Patients
   Case Report
   Jyotsna Punj, MD, Longjam Darendrajit Singh, MD, Heena Garg, MD, Dhruv Jain, MD, Jay Prakash Thakur, MD, and Gaurav Gomez, MD.

BACKGROUND: We describe a new method of ultrasound-guided lumbar transforaminal injection with an electrical stimulation needle (NsUTFI) in 2 patients with disc herniation at the L5-S1 and L4-L5 levels, respectively. The patient provided HIPAA compliant consent for the inclusion of their clinical information in this report.

CASE REPORT: NsUTFI was performed by eliciting sensory and/or motor stimulation of nerve roots by an electrical stimulation needle, which was inserted in an out-of-plane (OOP) trajectory just beyond the intertransverse ligament between the appropriate 2 transverse processes via  a paramedian sagittal oblique (PSO) approach with a curved probe. Fluoroscopic confirmation was not done. Both patients reported 50% pain reduction at 2 weeks’ follow-up. 

CONCLUSION: We conclude that a new technique for lumbar radicular pain with NsUTFI with a PSO OOP needle trajectory at the intertransverse ligament may be safe and effective and should be further explored.

KEY WORDS: Electrical stimulation, paramedian sagittal oblique, transforaminal injection, ultrasound

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