Ultrasound-Guided Lumbar Intradiscal Injection for Discogenic Pain: Technical Innovation and Presentation of Two Cases.

intervertebral disc low back pain lumbar spine platelet-rich plasma ultrasound

Journal

Journal of pain research
ISSN: 1178-7090
Titre abrégé: J Pain Res
Pays: New Zealand
ID NLM: 101540514

Informations de publication

Date de publication:
2020
Historique:
received: 09 03 2020
accepted: 01 05 2020
entrez: 18 6 2020
pubmed: 18 6 2020
medline: 18 6 2020
Statut: epublish

Résumé

We described two cases and the techniques for using the ultrasound (US) to guide lumbar intradiscal injection with platelet-rich plasma (PRP). The two cases suffered from chronic low back pain. Magnetic resonance imaging revealed posterior annular tear of the L5/S1 intervertebral disc (IVD) in the first case and L4/5 and L5/S1 IVDs in the second case. For the US-guided lumbar intradiscal injection, the patient was placed in a prone position. By placing the transducer in the axial plane at the interlaminar space, the needle was directed toward the center of the aimed IVD. The needle tip was ensured inside the IVD by using the end-feel of sudden reduction of resistance and the poking technique with the transducer oriented in the paramedian sagittal oblique plane. At the follow-up, both patients had significant improvement after the intradiscal PRP injections (visual analogue scale from 7.5 to 1.5 on average). The report indicated US-guided lumbar intradiscal PRP injection to be a feasible approach for treatments of low back pain. Familiarization of the anatomy and sonoanatomy of the lumbar spine is fundamental to achieve the success of intradiscal injection.

Identifiants

pubmed: 32547174
doi: 10.2147/JPR.S253047
pii: 253047
pmc: PMC7245455
doi:

Types de publication

Case Reports

Langues

eng

Pagination

1103-1107

Informations de copyright

© 2020 Wu et al.

Déclaration de conflit d'intérêts

The authors declared no conflict of interest existed.

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Auteurs

Tsung-Ju Wu (TJ)

Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan.
Department of Physical Medicine and Rehabilitation, Yuanlin Christian Hospital, Changhua, Taiwan.

Chen-Yu Hung (CY)

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.

Chih-Wei Lee (CW)

Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan.

Stanley Lam (S)

Department of Family Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.

Thomas B Clark (TB)

Private Practice Ultrasonographic Training, Vista, CA, USA.

Ke-Vin Chang (KV)

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.

Classifications MeSH