Fluoroscopically guided lumbar facet joint injection using an interlaminar approach and loss of resistance technique

Abstract

Purpose: 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.

Materials and 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.

Conclusion: 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.

Keywords: Facet joint; Fluoroscopy; Injection; Spine.