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Lumbar Facet Nerve Block: Ultrasound 

Lumbar Facet Nerve Block: Ultrasound
Lumbar Facet Nerve Block: Ultrasound
Multimodality Imaging Guidance in Interventional Pain Management

David A. Provenzano


This chapter describes the relevant anatomy and sonoanatomy and the ultrasound-guided technique for lumbar medial branch blocks. The ultrasound-guided lumbar medial branch block is an intermediate level block. Prior to performing this block, it is important to have a detailed understanding of lumbar sonoanatomy in order to be able to target the correct level, the lumbar medial branch and the L5 dorsal ramus zones. In those individuals with body mass indexes in the ideal range, current studies suggest the L3 and L4 medial branches can be successfully targeted. The L5 dorsal ramus may be challenging secondary to the iliac crest, which may limit the ultrasound views needed for the target zone. Further technical and equipment advancements are needed to improve and reduce the existing limitations associated with the ultrasound-guided lumbar medial branch block technique.

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