title: Fluoroscopically guided lumbar facet joint injection using an interlaminar approach and loss of resistance technique.
abstract: OBJECTIVE
  To describe a new technique for performing fluoroscopically guided lumbar facet joint injections using an interlaminar approach and loss-of-resistance technique and to report the initial success rate of this technique in a small series of patients.
  
  
  METHODS
  The institutional radiology database was retrospectively reviewed to identify patients who underwent fluoroscopically guided lumbar facet joint injections. Between 1 May 2014 and 31 October 2015, one radiologist attempted fluoroscopically guided lumbar facet joint injections using an interlaminar approach and loss-of-resistance technique in ten severely osteoarthritic facet joints (4 patients). Patient demographics, facet joint side and level, and whether or not an intra-articular facet joint injection was achieved were recorded.
  
  
  RESULTS
  Intra-articular injection was achieved using the interlaminar approach and loss-of-resistance technique in five facet joints.
  
  
  CONCLUSIONS
  Fluoroscopically guided lumbar facet joint injection using an interlaminar approach and loss-of-resistance technique is an alternative approach to a direct posterior facet joint injection and may be particularly useful for severely osteoarthritic facet joints, where bulky osteophytes and/or extreme curvature of the joints in the transverse plane threaten to preclude direct posterior access to the joints.
authors.affiliation: Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA. ajhuang@mgh.harvard.edu.
authors.forename: Ambrose J
authors.initials: AJ
authors.lastname: Huang
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D055013:Osteoarthritis, Spine / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D015641:Radiography, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging*
chemical_list: D000893:Anti-Inflammatory Agents; D013256:Steroids
keywords: Facet joint; Fluoroscopy; Injection; Spine
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