Images of Gray Rami Block

[mehul_25]

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anyone have images of a gray rami block that they would be willing to share or post?

 

[drusso]

...and I would like to see a picture of a unicorn.

 

[PMR 4 MSK]

...and I would like to see a picture of a unicorn.

Your wish...

 

[drusso]

Your wish...

It looks like a regular old pony with a horn! Now, why do I have a feeling that a GRC block is going to look an awful lot like a regular old lumbar sympathetic block.... 🙄

 

[lobelsteve]

It looks like a regular old pony with a horn! Now, why do I have a feeling that a GRC block is going to look an awful lot like a regular old lumbar sympathetic block.... 🙄

Just an inch or two more posterior, and more midbody than top of 3 or bottom of 2.

Look at Bogduk's L Spine and Sacrum book (the yellow and blue)- it is a neural net from the foramen to the sympathetic trunk. We would do the GRC at midbody with superior end plate squared in both AP/Lat views.

 

[ampaphb]

Just an inch or two more posterior, and more midbody than top of 3 or bottom of 2.

Look at Bogduk's L Spine and Sacrum book (the yellow and blue)- it is a neural net from the foramen to the sympathetic trunk. We would do the GRC at midbody with superior end plate squared in both AP/Lat views.

for me, GRC blocks strike me potentially appropriate on those patients who are discography positive, and have already failed PDD (or insurance won't approve it). As with intra-discal steroids, it is the last thing I might consider doing before making a surgical referral

 

[drusso]

Just an inch or two more posterior, and more midbody than top of 3 or bottom of 2.

Look at Bogduk's L Spine and Sacrum book (the yellow and blue)- it is a neural net from the foramen to the sympathetic trunk. We would do the GRC at midbody with superior end plate squared in both AP/Lat views.

Using viscous lidocaine? 😀

No, I "get it." I just think that the injectate spreads...a lot...and distinguishing between the two blocks is difficult. Have you ever checked lower extremity temperatures after GRC's?

 

[Disciple]

.

 

[Jcm800]

the difference between Rami block and LSNB is probably theoretical, as i dont think i could selectively block one versus another do to the volume of he block (and i use small volumes) RF, maybe could be done selectively...

 

[lobelsteve]

the difference between Rami block and LSNB is probably theoretical, as i dont think i could selectively block one versus another do to the volume of he block (and i use small volumes) RF, maybe could be done selectively...

GRC's are done with 0.5-1 cc of local.
LSB's are done with 8-15cc's.

 

[Jcm800]

GRC's are done with 0.5-1 cc of local.
LSB's are done with 8-15cc's.

that is a valid point.

 

[medicineman1]

Any updates on using this technique at L2 for "any level" discogenic back pain? I have read Oh & Shim articles, as well as Chandler & Dalley (talking about indication for vertebral compression fracture). Any other good articles? LobelSteve was talking sometime back about doing case report series, how is this coming along? Any opinions on the best illustrations of the anatomy? LobelSteve mentioned Bogduk's L Spine and sacrum book-
Any responses or comments appreciated-

 

[medicineman1]

clarification, ....injecting at L2 for any Lumbar discogenic back pain...