SIS (ISIS) - Lumbar MBB technique

[NJPAIN]

I'm test driving the official ISIS lumbar MBB technique to see if I want to switch and would like to hear if others are using it with success.
It employs a "declined view". Are others using this declined view and if so how much caudal II tilt and in the oblique or AP view? It makes no mention of a lateral view, have others eliminated that view? Finally, how are others determining the "optimal Scottie dog view" for oblique needle placement?

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[pastafan]

No lateral. Declined ~40 degrees. I tried to paste slides from Milton Lander's presentation. If you PM an email address I will send it to you.

 

[Taus]

RF yes of course decline view, but not sure I understand why you would want or need to caudal tilt/decline view for the mbb. I oblique just enough til I see a clear sap/tp junction, hit os, inject.

 

[NJPAIN]

RF yes of course decline view, but not sure I understand why you would want or need to caudal tilt/decline view for the mbb. I oblique just enough til I see a clear sap/tp junction, hit os, inject.

Per the ISIS book, to see the needle tip in the groove/notch between SAP and TP. Great concept if you ask me and pictures in book are convincing I'm just having a tough time putting it all together to get optimal needle placement. Obviously if your angles are off you are not where you think you are.

 

[Taus]

Per the ISIS book, to see the needle tip in the groove/notch between SAP and TP. Great concept if you ask me and pictures in book are convincing I'm just having a tough time putting it all together to get optimal needle placement. Obviously if your angles are off you are not where you think you are.

For RF yes, but mbb? Notch on oblique is fine.. would take a lot to convince me that my 1/2cc lido will miss nerve it if a mm or 2 off.

 

[willabeast]

i use 25 degree oblique with VB squared off to place needle for MBB, but sometimes check a 30 or 40 degree caudal tilt with no rotation to make sure i am in the groove before i inject.

 

[bedrock]

For RF yes, but mbb? Notch on oblique is fine.. would take a lot to convince me that my 1/2cc lido will miss nerve it if a mm or 2 off.

Agree. I take time on my MBB, but not all day.

I check the extra angles on RF.

 

[PinchandBurn]

Some guys juat do a AP. Drop needles at sap/tp jxn. Check lateral for nothing in foramen. Then inject. ...for rfa different story, so the decline view etc

 

[Papa Lou]

you guys know you get a little thumb heavy on that "1/2 cc"

 

[lobelsteve]

you guys know you get a little thumb heavy on that "1/2 cc"

You mean 1/2 ounce?