Comparison of the use of peripheral nerve stimulator and quincke needle for lumbar transforaminal epidural steroid injections
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Abstract:
To compare the procedural features of transforaminal epidural steroid injection (TFESI) performed using two different needles (Stimuplex® and Quincke) in terms of procedure time, exposed radiation dose and adverse effects and complications, thus providing preliminary data to aid needle selection for TFESI.Keywords:
Epidural steroid injection
Nerve stimulator
Peripheral nerve stimulation
Fluoroscopically guided lumbar transforaminal epidural steroid injections are indicated for the treatment of lumbar radicular pain that has failed more conservative options. This article details proper equipment and medications, patient positioning and set-up, step-by-step instructions for multiplanar fluoroscopic visualization, needle advancement and medication instillation, and postoperative management. Pearls and pitfalls are also discussed. In addition, an instructional procedure video accompanies this paper.
Epidural steroid injection
Radicular pain
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Peripheral nerve stimulation
Nerve stimulation
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This newly designed peripheral nerve stimulator allows the scrubbed anaesthetist performing a nerve block to adjust the electrical current output needed for localisation of the target nerve without the need for an assistant.
Nerve stimulator
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The authors describe use of the nerve stimulator in conjunction with a percutaneous exploring needle to achieve peripheral blocks accurately and without injuring the nerve. The nerve stimulator allows accurate nerve blocks without causing paresthesiae and the need for additional anesthetic. This technique decreases the possibility of nerve injury.
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