Open AccessTechnical challenges of performing S1 root block: role for double needle and multilevel needle technique
Author(s) -
Sanjeeva Gupta,
Harun Gupta,
Ganesan Baranidharan,
Manohar Sharma
Publication year - 2020
Publication title -
british journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.642
H-Index - 15
eISSN - 2049-4645
pISSN - 2049-4637
DOI - 10.1177/2049463720960497
Subject(s) - medicine , nerve root , contrast (vision) , magnetic resonance imaging , nerve block , block (permutation group theory) , radiology , anatomy , computer science , geometry , mathematics , artificial intelligence
S1 root block is performed for pain in the lower limbs due to S1 nerve root inflammation at the L5/S1 disc level or compression in the lateral recess. We often note anterior or posterior spread of contrast away from the L5/S1 disc through an anatomically appropriate needle tip placement. We frequently encounter vascular spread when performing S1 root blocks, and the reported incidence varies between 10.4% and 27.8%. There is no clear strategy published to manage these challenges. In such clinical scenarios, we propose a double needle and/or a multilevel needle technique.