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Hello doctors. It is a technical video.
Practice makes perfect.
Repeated observation of procedures will improve your skills and train your brain to learn quickly."
It is case 1. I will perform the left L5 transforaminal subpedicular injection with an augmented left 4-5 facet joint via the inferior recess.
It is case 2. I will perform the right L5 transforaminal subpedicular injection with an augmented right 4-5 facet joint via the inferior recess.
I tried to perform an augmented right L4 infraneural transforaminal injection, but I penetrated the annulus of the L4-5 disc with contrast media spread to the disc. So, I will switch to the left L4-5 facet joint injection through the inferior recess.
It is case 3.
In this case, there is a spondylolisthesis with severe foraminal stenosis at the right L5-S1 level, and it has been decided to perform a right L5 transforaminal injection. However, it is believed that the steroid and medication alone may not be sufficient to reach the foraminal space, so a right L5-S1 facet joint injection has also been planned. Since the contrast used in the transforaminal injection may obscure the view of the facet joint during the injection, it has been decided to perform the facet joint injection first, followed by the transforaminal injection. This order is being reversed from the usual procedure, where the transforaminal injection is performed before the facet joint injection, as the needle's contact with bone during the facet joint injection may damage the sharp blade and make the second needle insertion more painful.
It is case 4. I will perform bilateral L3 infraneural transforaminal injection. I usually do bilateral infraneural transforaminal injections in case of discogenic low back pain due to an annular tear.
It is the last case. I will perform the right L5 transforaminal subpedicular approach.
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26 авг 2024