Korean J Pain.  2017 Jan;30(1):66-70. 10.3344/kjp.2017.30.1.66.

A brief report on a technical description of ultrasound-guided lumbar sympathetic block

• Moon JY
• Choi JK
• Shin JY
• Chon SW
• Dev S

• KMID: 2365344
• DOI: http://doi.org/10.3344/kjp.2017.30.1.66

Abstract

The lumbar sympathetic ganglion block (LSGB) is widely used for diagnosing and treating sympathetically maintained pain disorders. The LSGB has been conventionally carried out under fluoroscopy or computed tomography guidance. However, as ultrasound technology improved, ultrasound-guided interventions have been expanding their territory to deeper structures. Ultrasound guidance provides many benefits including protecting vascular injection, shortening procedure time in some cases, and reducing the emission of radiation. In this report, we describe a successful case of a US-guided LSGB without major complications. We expect that US-guided LSGBs can be implemented and furnished in the daily outpatient clinical setting by highly trained pain physicians.

Keyword

Complex regional pain syndrome; Lumbar sympathetic block; Neuropathic pain; Psoas muscle; Sympathetic block; UItrasonography

MeSH Terms

Fluoroscopy
Ganglia, Sympathetic
Humans
Neuralgia
Outpatients
Psoas Muscles
Ultrasonography

Figure

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  Fig. 1 Paramedian sagittal image of lumbosacral junction. A target vertebra level is usually identified by locating probe at the lumbosacral junction (L5-S1 gap) and by numbering the lamina and transverse processes upward (blue arrow).

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  Fig. 2 Modified transverse image of the lumbar paravertebral region through lumbar inter-transverse space. A yellow star shows anterior fascia of the psoas major muscle. PS: psoas major muscle, QL: quadratus lumborum muscle.

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  Fig. 3 Modified transverse image of the lumbar paravertebral region through lumbar inter-transverse space. Arrow heads point a needle shaft and a yellow star shows anterior fascia of the psoas major muscle. Ps: psoas major muscle, QL: quadratus lumborum muscle.

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  Fig. 4 (A) An anteroposterior fluoroscopic view with a needle and spread of contrast medium, (B) A lateral fluoroscopic view.

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