title: Targeting the spinal nerve via a double-needle, transforaminal approach in failed back surgery syndrome: demonstration of a technique.
abstract: Spinal surgery, particularly spinal fusion surgery, alters the anatomy of the spine and hence, may increase the difficulty of performing an interventional spine procedure. Transforaminal epidural procedures have gained popularity as an alternative to interlaminar epidural steroids in the management of radicular pain syndromes. Patients with failed back surgery syndrome are often excluded or represent a minor subset in many clinical studies evaluating the efficacy of transforaminal procedures. When included, however, patients with FBSS have typically undergone laminectomies or microdiscectomies: these procedures are less likely to violate the foraminal space in the spine compared to fusion surgery. We describe the specific details of a transforaminal approach to the epidural space/spinal nerve in a patient with a posterolateral and posterior interbody fusion.
authors.affiliation: Department of Anesthesiology, Pain Division, Texas Tech University Health Sciences, Center / International Pain Institute, 4430 South Loop 289, Lubbock, Texas 79414, USA. rinoo_shah@yahoo.com
authors.forename: Rinoo V
authors.initials: RV
authors.lastname: Shah
authors.forename: Wesley
authors.initials: W
authors.lastname: Merritt
authors.forename: Dwayne
authors.initials: D
authors.lastname: Collins
authors.forename: Gabor B
authors.initials: GB
authors.lastname: Racz