CT-assisted chemonucleolysis.
The safety and success rate of chemonucleolysis are largely dependent on correct needle insertion. The neurological complications of chemonucleolysis are related to inadvertent puncture of the dura, nerve root and/or spinal nerve. To avoid this complication, a puncture angle of 50 degrees to 60 degrees above the sagittal plane is widely recommended (1). Our CT study of the location of the spinal nerve L4-L5 and L5-S1 demonstrates a great variability of this location and also explains some of the possible hazards of 50 degrees to 60 degrees puncture (2). The CT-evaluation of the relationship between the nerve root, spinal nerve and apophyseal joint with respect to the puncture angle is suitable. In our experience, this method is helpful for fast, safe and easy insertion of the needle.
Stadnik
T W
TW
Department of Radiology and Medical Imaging University Hospital V.U.B., Brussels, Belgium.
van Tussenbroek
F M
FM
Luypaert
R R
RR
Osteaux
M
M
D006801:Humans; D007404:Intervertebral Disc Chemolysis / Q000009:adverse effects / Q000379:methods*; D009339:Needles; D013127:Spinal Nerves / Q000033:anatomy & histology; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*