An Analysis of Location of Needle Entry Point andPalpated PSIS in S1 Nerve Root Block
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Background:The first sacral nerve root block (S1NRB) is a common procedure in pain clinic for patients complaining of low back pain with radiating pain. It can be performed in the office based setting without C-arm. The previously suggested method of locating the needle entry point begins with identifying the posterior superior iliac spine (PSIS). Then a line is drawn between two points, one of which is 1.5 cm medial to the PSIS, and the other of which is 1.5 cm lateral and cephalad to the ipsilateral cornu. After that, one point on the line, which is 1.5 cm cephalad to the level of the PSIS, is considered as the needle entry point. The purpose of this study was to analyze the location of needle entry point and palpated PSIS in S1NRB. Methods:Fifty patients undergoing C-arm guided S1NRB in the prone position were examined. The surface anatomical relationships between the palpated PSIS and the needle entry point were assessed. Results:The analysis revealed that the transverse and vertical distance between the needle entry point and PSIS were 28.7 ± 8.8 mm medially and 3.5 ± 14.0 mm caudally, respectively. The transverse distance was 27.8 ± 8.3 mm medially for male and 29.5 ± 9.3 mm medially for female. The vertical distance was 1.0 ± 14.1 mm cranially for male and 8.1 ± 12.7 mm caudally for female. Conclusions:The needle entry point in S1NRB is located on the same line or in the caudal direction from the PSIS in a considerable number of cases. Therefore previous recommended methods cannot be applied to many cases. (Korean J Pain 2010; 23: 242-246)
Abstract
Background:The first sacral nerve root block (S1NRB) is a common procedure in pain clinic for patients complaining of low back pain with radiating pain. It can be performed in the office based setting without C-arm. The previously suggested method of locating the needle entry point begins with identifying the posterior superior iliac spine (PSIS). Then a line is drawn between two points, one of which is 1.5 cm medial to the PSIS, and the other of which is 1.5 cm lateral and cephalad to the ipsilateral cornu. After that, one point on the line, which is 1.5 cm cephalad to the level of the PSIS, is considered as the needle entry point. The purpose of this study was to analyze the location of needle entry point and palpated PSIS in S1NRB. Methods:Fifty patients undergoing C-arm guided S1NRB in the prone position were examined. The surface anatomical relationships between the palpated PSIS and the needle entry point were assessed. Results:The analysis revealed that the transverse and vertical distance between the needle entry point and PSIS were 28.7 ± 8.8 mm medially and 3.5 ± 14.0 mm caudally, respectively. The transverse distance was 27.8 ± 8.3 mm medially for male and 29.5 ± 9.3 mm medially for female. The vertical distance was 1.0 ± 14.1 mm cranially for male and 8.1 ± 12.7 mm caudally for female. Conclusions:The needle entry point in S1NRB is located on the same line or in the caudal direction from the PSIS in a considerable number of cases. Therefore previous recommended methods cannot be applied to many cases. (Korean J Pain 2010; 23: 242-246)
참고문헌 (10)
- Wolff AP, "Diagnostic lumbosacral segmental nerve blocks with local anesthetics: a prospective double- blind study on the variability and interpretation of segmental effects", Reg Anesth Pain Med, 26, pp.147~155 (2001)
- Buckley FP, "Regional anesthesia with local anesthetics. In: Bonica's management of pain. 3rd", pp.1924~ (2000), Lippincott Williams & Wilkins
- Ojala R, "Nerve root infiltration of the first sacral root with MRI guidance", J Magn Reson Imaging, 12, pp.556~561 (2000)
- Quinn SF, "CT-guided nerve root block and ablation", AJR Am J Roentgenol, 151, pp.1213~1216 (1988)
- Finch PM, "Functional anatomy of the spine. In: Interventional pain management", pp.39~64 (1996), WB Saunders
- Phillip OB, "The lower extremity: Somatic blockade. In: Neural blockade in clinical anesthesia and management of pain. 3rd ed", pp.377~378 (1998), Lippincott-Raven
- Hasan ST, "Surface localization of sacral foramina for neuromodulation of bladder function. An anatomical study", Eur Urol, 29, pp.90~98 (1996)
- Cheng JS, "Anatomy of the sacrum", Neurosurg Focus, 15, pp.1~4 (2003)
- Başaloğlu H, "Morphometry of the sacrum for clinical use", Surg Radiol Anat, 27, pp.467~471 (2005)
- Asher MA, "Anthropometric studies of the human sacrum relating to dorsal transsacral implant designs", Clin Orthop Relat Res, 203, pp.58~62 (1986)