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Parasagittal needle placement approach for lumbar medial branch denervation: a brief technical report
  1. John Tran1,2,
  2. Arden Lawson3,
  3. Anne Agur1 and
  4. Eldon Loh2,3
  1. 1 Surgery (Division of Anatomy), University of Toronto, Toronto, Ontario, Canada
  2. 2 Department of Physical Medicine and Rehabilitation, Western University, London, Ontario, Canada
  3. 3 Lawson Health Research Institute, London, Ontario, Canada
  1. Correspondence to Dr John Tran, Surgery (Division of Anatomy), University of Toronto, Toronto, Canada; johnjt.tran{at}utoronto.ca

Abstract

Radiofrequency denervation of lumbar medial branches is a viable treatment option to manage chronic facetogenic low back pain. Traditionally, lumbar medial branch denervation involves placement of the electrode’s active tip at a 20-degree angulation away from the parasagittal plane. However, more recent anatomical studies have provided evidence supporting the feasibility of an alternative parasagittal approach targeting the posterior half of the lateral neck of the superior articular process to capture the lumbar medial branches. Currently, there is a lack of clinical data on the effectiveness of the alternative parasagittal needle placement technique. Therefore, in this brief technical report, the parasagittal needle placement technique and the pain relief outcomes in four consecutive patients following treatment with the parasagittal approach are described.

  • Back Pain
  • Pain Management
  • CHRONIC PAIN

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Footnotes

  • X @JTNerveGuyPhD, @LohEldon

  • Contributors JT, AL, AA and EL contributed to the data acquisition, analysis of data, drafting and revising the manuscript critically for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.