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Superior Cluneal Nerve Injection: Difference between revisions
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{{procedure | {{procedure | ||
|image=SCN block2.PNG | |image=SCN block2.PNG | ||
|indication=Cluneal | |indication=[[Cluneal Nerve Pain]] | ||
|syringe=10mL | |syringe=10mL | ||
|needle=80mm nerve block needle | |needle=80mm nerve block needle | ||
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===Ultrasound Guided=== | ===Ultrasound Guided=== | ||
;SCN Injection | |||
An ultrasound guided technique for superior cluneal nerve entrapment has been developed, in a cadaveric and live human randomised study.<ref>{{#pmid:31061111}}</ref> | An ultrasound guided technique for superior cluneal nerve entrapment has been developed, in a cadaveric and live human randomised study.<ref>{{#pmid:31061111}}</ref> | ||
*Position: | *Position:Lateral decubitus | ||
*Target: Subfascial layer between the thoracolumbar fascia and erector spinae to ensure injectate spread to all superior cluneal nerves. | *Target: Subfascial layer between the thoracolumbar fascia and erector spinae to ensure injectate spread to all superior cluneal nerves. | ||
*Probe:High frequency linear transducer. | *Probe:High frequency linear transducer. | ||
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===Landmark Guided=== | ===Landmark Guided=== | ||
;SCN Injection | |||
*Position: Prone | |||
*Palpate: posterior wings of the iliac crest, 6-7cm lateral from the midline, and mark the area. Often there is a small lipoma, and use this to guide needle placement around the lipoma. | |||
*Advance needle perpendicularly to the marked area under contact with bone. | |||
*Following negative aspiration inject 1mL of solution | |||
==Complications== | ==Complications== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
{{Reliable sources|synonym1="cluneal nerve"}} | |||
[[Category:Infoboxes]] | [[Category:Infoboxes]] | ||
[[Category:Pelvis, Hip | [[Category:Nonmainstream Articles]] | ||
[[Category: | [[Category:Pelvis, Hip and Thigh Procedures]] | ||
[[Category:Lumbar Spine Procedures]] | |||
[[Category:Stubs]] | [[Category:Stubs]] |
Latest revision as of 15:09, 6 June 2021
This article is a stub.
Superior Cluneal Nerve Injection | |
---|---|
Indication | Cluneal Nerve Pain |
Syringe | 10mL |
Needle | 80mm nerve block needle |
Steroid | optional |
Local | doctor choice |
Volume | ?10-15mL |
Anatomy
Indications
Contraindications
Pre-procedural Evaluation
Equipment
Technique
Injection can be done by landmark guided palpation based on the maximal area of tenderness, and/or by ultrasound guidance. Injections are typically done with local anaesthetic, but dextrose prolotherapy can be used[1]
Ultrasound Guided
- SCN Injection
An ultrasound guided technique for superior cluneal nerve entrapment has been developed, in a cadaveric and live human randomised study.[2]
- Position:Lateral decubitus
- Target: Subfascial layer between the thoracolumbar fascia and erector spinae to ensure injectate spread to all superior cluneal nerves.
- Probe:High frequency linear transducer.
- Identify the lateral border of the erector spinae muscle at the level of the superior margin of the iliac crest, which fuses laterally with the transverse abdominis aponeurosis.
- Trace the erector spinae caudally to the level of the iliac crest
- Keep the transducer cranial to the level of where the lumbar intermuscular aponeurosis fuses with the posterior layer of the thoracolumbar fascia.
- Insert needle lateral to medial, pierce the thoracolumbar fascia just medial to the point of fusion with the anterior layer at the lateral margin of the erector spinae.
- The erector spinae muscle and posterior layer of the thoracolumbar fascia should separate during injection, and as this happens move the needle medially.
Fluoroscopy Guided
Landmark Guided
- SCN Injection
- Position: Prone
- Palpate: posterior wings of the iliac crest, 6-7cm lateral from the midline, and mark the area. Often there is a small lipoma, and use this to guide needle placement around the lipoma.
- Advance needle perpendicularly to the marked area under contact with bone.
- Following negative aspiration inject 1mL of solution
Complications
Aftercare
Videos
See Also
External Links
References
Literature Review
- Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf
- Articles from all years: PubMed search, Google Scholar search.
- TRIP Database: clinical publications about evidence-based medicine.
- Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,