Saudi Journal of Anaesthesia

LETTERS TO EDITOR
Year
: 2019  |  Volume : 13  |  Issue : 4  |  Page : 398--399

Regarding the paper published ‘Ultrasound-guided lumbar transforaminal injection through interfacet approach’


Preeti Soni, Jyotsna Punj 
 Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Dr. Jyotsna Punj
Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi - 110 029
India




How to cite this article:
Soni P, Punj J. Regarding the paper published ‘Ultrasound-guided lumbar transforaminal injection through interfacet approach’.Saudi J Anaesth 2019;13:398-399


How to cite this URL:
Soni P, Punj J. Regarding the paper published ‘Ultrasound-guided lumbar transforaminal injection through interfacet approach’. Saudi J Anaesth [serial online] 2019 [cited 2019 Oct 17 ];13:398-399
Available from: http://www.saudija.org/text.asp?2019/13/4/398/266002


Full Text



To the Editor,

I read the paper “Ultrasound-guided lumbar transforaminal injection (USTFI) through interfacet approach” by Kumar et al. with great interest.[1] I congratulate the authors for this excellent report. However, we have certain queries.

It is not clear from the article if the present technique for USTFI was validated in patients. It would be informative to know the number of recruited patients in which the technique was performed.

The authors have mentioned use of a linear probe to perform USTFI. However, to the best of our knowledge, all but one study on USTFI have used a curved probe for the block due to deep location of neuraxial structures.[2] A linear probe was used in a study when recruited patients had body mass index of less than 25 kg/m 2.[3]

We are also confused about the orientation of the probe when needle was inserted. The authors mention that the probe was moved medially to laterally in parasagittal plane till trident sign (parasagittal probe orientation at the level of transverse process) was seen. However, the authors mention needle advancement between two articular processes. This is contradictory.

The present technique was documented as a new technique. However, three authors previously have mentioned USTFI by similar techniques; two in out of plane interfacet approach and one by parasagittal oblique plane block.[3],[4],[5]

The authors used fluoroscopy to confirm needle tip position by dye spread, however patterns of dye spread, which are confirmatory for the block, were not mentioned.

There seems to be a typing/printing error in the figure accompanying the article.[1] Superior articular process and inferior articular process mentioned seem to be facet joint of successive lumbar verterbrae.

We would also like to mention that one cited reference is not indexed in PubMed.[1]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Kumar A, Sinha C, Bhadani UK, Sharma S. Ultrasound-guided lumbar transforaminal injection through interfacet approach. Saudi J Anaesth 2018;12:169-70.
2Provenzano DA, Narouze S. Sonographically guided lumbar spine procedures. J Ultrasound Med 2013;32:1109-16.
3Wan Q, Wu S, Li X, Lin C, Ke S, Liu C, et al. Ultrasonography guided lumbar periradicular injections for unilateral radicular pain. Biomed Res Int 2017;2017:8784149.
4Yang G, Liu J, Ma L, Cai Z, Meng C, Qi S, et al. Ultrasound-guided versus fluoroscopy-controlled lumbar transforaminal epidural injections: A prospective randomized clinical trial. Clin J Pain 2016;32:103-8.
5Kim YH, Park HJ, Moon DE. Ultrasound-guided pararadicular injection in the lumbar spine: A comparative study of the paramedian sagittal and paramedian sagittal oblique approaches. Pain Pract 2015;15:693-700.