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The object of this study is to introduce a novel USG approach for lumbar periradicular injections by investigating radicular artery nearby (IRAN) technique and to assess the feasibility and preliminary means by fluoroscopy.  Study design: The USG periradicular injection is performed under real time imaging. An axial scanning view is obtained through identifying the spinous processes, lamina, zygapophyseal joints and transverse processes.  Setting: The curve probe put transversally and the needle site check in axial and sagittal view.  Methods: The IRAN technique was defined by sliding probe a little lower under the facet joint in sagittal plane to view the pulse of nearby radicular artery by Doppler or Pulse Echo. Then spinal needles are advanced with in-plane technique toward the artery until touch the nearby bone.  Results: Fluoroscopy examination confirms that the needle tip is correctly placed under the pedicle along the nerve root and lateral to the pars interarticularis with no intravascular injection.  Limitation: Although searching for small vessels is difficult in cadaver studies, the IRAN technique would be confirmed in the future on Cadaver.  Conclusion: The IRAN technique as a new anatomic landmark allow an easy and corrected periradicular placement of the needle.

A novel ultrasound guided approach for lumbar periradicular injections with investigating the radicular artery nearby (IRAN) technique