Lumbar Transitional Pseudoarthrosis Injection

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  • Patient prone with pillow under pelvis
  • Obtain transverse view of target injection site
  • Identify lateral to the spinous process the multifidus muscle, facet joint, transverse process, iliac crest, and the pseudoarthrosis of the L5 transverse process with the iliac crest.
  • Insert needle using an in-plane approach with an approximate angle of 45-60 degrees lateral to the facet joint, medial to lateral, into the pseudoarthrosis.

See images by Chen and colleagues.[1]

See Also

Transitional Vertebral Anatomy


  1. Chen, Zhi-Jia; Cheng, Wei-Jen; Chen, Jean-Lon; Chen, Chien-Hung; Chen, Carl P. C. (2022-01-01). "Ultrasound-Guided Injection Treatment of Low Back Pain Caused by Bertolotti Syndrome". American Journal of Physical Medicine & Rehabilitation. 101 (1): e15–e16. doi:10.1097/PHM.0000000000001810. ISSN 1537-7385. PMID 34915547.