Survey of Sonoanatomic Distances For Lumbar Medial Branch Nerve Blocks in Healthy Volunteers
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: The precise knowledge of anatomy and the region of transverse process (TP) and superior articular processes (AP) and their distance from the skin are important in blocking and treating lumbar facet syndrome. Evaluation of these anatomic distances from 3rd and 5th lumbar vertebrae in both sides and in different body mass index (BMI) in healthy volunteers might improve knowledge of ultrasound (US) lumbar medial branch nerve blocks (LMBB). Methods: Bilateral US in the 3rd and 5th lumbar vertebrae of 64 volunteers carried out and the distance between skin to TP and skin to AP was measured. These distances were compared on both sides and in different BMI groups. The analysis was done using SPSS 11. Analysis of variance was used to compare the means at three vertebral levels (L3−L5) and different BMI groups. P values less than 0.05 were considered statistically significant. The paired t-test was used to compare the mean distance between skin to TP and skin to AP on both sides. Results: The distance between skin to TP and skin to AP of 3rd vertebrae to 5th vertebrae was increased in both right and left sides (P ＜ 0.001) from up to down. The mean distance from skin to TP were greater on the left side compared to the right in all three vertebral levels from L3 to L5 (P values 0.014, 0.024, and 0.006 respectively). The mean distance from skin to TP and the skin to AP was statistically significant in different BMI groups (P ＜ 0.001). Conclusions: We found many anatomic distances which may increase awareness of US guided LMBB.
Abstract
Background: The precise knowledge of anatomy and the region of transverse process (TP) and superior articular processes (AP) and their distance from the skin are important in blocking and treating lumbar facet syndrome. Evaluation of these anatomic distances from 3rd and 5th lumbar vertebrae in both sides and in different body mass index (BMI) in healthy volunteers might improve knowledge of ultrasound (US) lumbar medial branch nerve blocks (LMBB). Methods: Bilateral US in the 3rd and 5th lumbar vertebrae of 64 volunteers carried out and the distance between skin to TP and skin to AP was measured. These distances were compared on both sides and in different BMI groups. The analysis was done using SPSS 11. Analysis of variance was used to compare the means at three vertebral levels (L3−L5) and different BMI groups. P values less than 0.05 were considered statistically significant. The paired t-test was used to compare the mean distance between skin to TP and skin to AP on both sides. Results: The distance between skin to TP and skin to AP of 3rd vertebrae to 5th vertebrae was increased in both right and left sides (P ＜ 0.001) from up to down. The mean distance from skin to TP were greater on the left side compared to the right in all three vertebral levels from L3 to L5 (P values 0.014, 0.024, and 0.006 respectively). The mean distance from skin to TP and the skin to AP was statistically significant in different BMI groups (P ＜ 0.001). Conclusions: We found many anatomic distances which may increase awareness of US guided LMBB.
참고문헌 (12)
- Saal JS, "General principles of diagnostic testing as related to painful lumbar spine disorders: a critical appraisal of current diagnostic techniques", Spine (Phila Pa 1976), 27, pp.2538~2545 (2002)
- Fujiwara Y, "Ultrasound-guided regional anesthesia and pain medicine", pp.240~251 (2010), Lippincott Williams & Wilkin
- Galiano K, "Ultrasound-guided versus computed tomographycontrolled facet joint injections in the lumbar spine : a prospective randomized clinical trial", Reg Anesth Pain Med, 32, pp.317~322 (2007)
- Galiano K, "Real-time sonographic imaging for periradicular injections in the lumbar spine: a sonographic anatomic study of a new technique", J Ultrasound Med, 24, pp.33~38 (2005)
- Kirchmair L, "A study of the paravertebral anatomy for ultrasound-guided posterior lumbar plexus block", Anesth Analg, 93, pp.477~481 (2001)
- Greher M, "Ultrasound-guided lumbar facet nerve block : a sonoanatomic study of a new methodologic approach", Anesthesiology, 100, pp.1242~1248 (2004)
- Galiano K, "Ultrasound guidance for facet joint injections in the lumbar spine : a computed tomographycontrolled feasibility study", Anesth Analg, 101, pp.579~583 (2005)
- Irwin DM, "Atlas of ultrasound-guided procedures in interventional pain management", pp.149~156 (2011), Springer
- Shim JK, "Ultrasound-guided lumbar medial-branch block: a clinical study with fluoroscopy control", Reg Anesth Pain Med, 31, pp.451~454 (2006)
- Greher M, "Ultrasound-guided lumbar facet nerve block:accuracy of a new technique confirmed by computed tomography", Anesthesiology, 101, pp.1195~1200 (2004)
- Rauch S, "Ultrasound-guided lumbar medial branch block in obese patients : a fluoroscopically confirmed clinical feasibility study", Reg Anesth Pain Med, 34, pp.340~342 (2009)
- 문진천, "초음파 유도하에서의 요추부 후관절 내측지 차단술을 위한 주요 척추 구조물의 거리 측정", The Korean Journal of Pain, 20(2), pp.5~5 (2007), 대한통증학회