Figure 183

Lumbar selective spinal nerve block, anteroposterior view.

A selective spinal nerve block can be done at the cervical (Figures 18-1 and 18-2), thoracic, lumbar (Figures 18-3 and 18-4), and sacral spinal levels.

Sacroiliac Joint Block

The intra-articular injection of an anesthetic solution is utilized to block the pain generation from this joint.

Indications A sacroiliac joint block is used to determine the role of this joint in the pain picture, especially in chronic low back pain workup.

Procedure The caudal portion of the joint is accessed under fluoroscopy, and 0.5 to 1 mL of contrast material is injected to visualize an arthro-gram (Figures 18-5 and 18-6). Generally 1 to 2 mL of local anesthetic is injected, and the patient is instructed to fill out the temporal pain diagram.

Intra-articular Zygoapophyseal Joint (ZJ) Block

The intra-articular injection of an anesthetic solution is utilized to block the pain generation from this joint.

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