I tried lateral. Very hard to visualize c6 and c7. It was quite nice for the more superior levels.
True. But with modified swimmer’s view it’s often not too difficult.
I tried lateral. Very hard to visualize c6 and c7. It was quite nice for the more superior levels.
I tried lateral. Very hard to visualize c6 and c7. It was quite nice for the more superior levels.
I understand what you’re saying but I have also used lateral almost exclusively for mbb the last 4-5 years. Most are on ancient spines. Not much rfa on younger outside occasional s/p whiplash. Just take a few mins to oblique image intensifier to line up posterior aspect articular pillars with the proper gap between spinolaminar line. Then tilt to head or feet to line up joint spaces. There will be some trial and error to get it right on each case, ie the way the body/head appears rotated may not be how you need to adjust c arm (may be all AA rotation) Also don’t worry about getting the entire c spine lined up. Just focus on the levels you are treating. Then the needle takes no time and is dead on accurate for mbb.If all of my patients anatomy looked like the one in the article I would have the best job in the world.
I understand what you’re saying but I have also used lateral almost exclusively for mbb the last 4-5 years. Most are on ancient spines. Not much rfa on younger outside occasional s/p whiplash. Just take a few mins to oblique image intensifier to line up posterior aspect articular pillars with the proper gap between spinous process. Then tilt to head or feet to line up joint spaces. Don’t worry about getting the entire c spine lined up. Just focus on the levels you are treating. Then the needle takes no time and is dead on accurate for mbb.
Instruct tech to make specific small moves like 2-3 degrees at a time.Do you grab the c-arm yourself or instruct the rad tech to make the movements?
I offered to try this with a very needle-phobic pt during mbbs. Literally, this one is buffered, this one is not. Again, buffered, not buffered. He said there was no difference. N=1.Where can one buy this or do you have to add bicarb yourself?
It makes a much bigger difference if you’re using lido with epi. The epi requires a much more acidic storage medium. I don’t use lido for most injections, where I use a 25g3.5” needle. I add bicarb to my local for RFA for faster onset. Maybe it stings a little less but I don’t see a clinically meaningful difference with or without from patient reactions.I offered to try this with a very needle-phobic pt during mbbs. Literally, this one is buffered, this one is not. Again, buffered, not buffered. He said there was no difference. N=1.
My n is several thousand. It makes a difference.I offered to try this with a very needle-phobic pt during mbbs. Literally, this one is buffered, this one is not. Again, buffered, not buffered. He said there was no difference. N=1.
I agree with this. I use it on local cases with a 20 or 22g needle... typically esi for hot radics. I think it makes a difference. I also don’t pay for it...My n is several thousand. It makes a difference.
technically is ethyl chloride truly sterile? I don't know, I just get a little freaked out spraying anything on my sterile field other than chlorhexidine immediately prior to needle insertion. This fear may all be in my head thoughWhy no love for ethyl chloride? It’s quick and easy.
I definitely agree. Especially for spinal procedurestechnically is ethyl chloride truly sterile? I don't know, I just get a little freaked out spraying anything on my sterile field other than chlorhexidine immediately prior to needle insertion. This fear may all be in my head though
technically is ethyl chloride truly sterile? I don't know, I just get a little freaked out spraying anything on my sterile field other than chlorhexidine immediately prior to needle insertion. This fear may all be in my head though
This was evaluated about a decade ago. No change in sterility to the field. One study showed even less cultures from the field after vapocoolant.technically is ethyl chloride truly sterile? I don't know, I just get a little freaked out spraying anything on my sterile field other than chlorhexidine immediately prior to needle insertion. This fear may all be in my head though