Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Feb 2019
CT angiography depicted lumbar spinal artery anatomic course: defining a safer zone for lumbar sympathetic and splanchnic blocks.
Determining safer techniques for lumbar injections is an important goal in pain medicine. This study aims to characterize the location of the T10-L5 spinal arteries using CT angiogram scans to define a safer approach for sympathetic and splanchnic blocks that minimizes intra-arterial injection. ⋯ Using routine anatomic landmarks visible on CT imaging, we classified the anatomic course of low thoracic and lumbar spinal arteries originating from the aorta into the neural foraminal space. A safe recommendation to avoid intra-arterial injection for a splanchnic or lumbar sympathetic is to start above the pedicle and add a slight caudal angulation to the needle trajectory to avoid disc injury at the anterolateral vertebral body.