Narouze Atlas of Ultrasound-Guided Procedures in Interventional Pain Management

1. Auflage 2010
ISBN: 978-1-4419-1681-5
Verlag: Springer US
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 372 Seiten

This book is the first and definitive reference in the growing field of ultrasonography in pain medicine. Each chapter details all you need to know to perform a specific block.  Comparative anatomy and sonoanatomy of the various soft tissues are featured, and tips and tricks for correct placement of the ultrasound probe and admimistration of the injection are described in detail.  All the major peripheral nerve blocks are discussed as well as the various injections of the spine, pelvis, and musculoskeletal system.

Samer N. Narouze, MD, MSc, DABPM, FIPP Chairman, Pain Management Department Summa Western Reserve Hospitals Cuyahoga Falls, OH, USA

Autoren/Hrsg.

Narouze, Samer N.

Inhaltsverzeichnis

1;Atlas of Ultrasound- Guided Procedures in Interventional PainManagement;3
1.1;Foreword;7
1.2;Preface;9
1.3;Acknowledgments;11
1.4;Contents;13
1.5;Contributors;25
1.6;1: Imaging in Interventional Pain Management;30
1.6.1;Introduction;30
1.6.1.1;C-Arm FDCT;32
1.6.1.2;Ultrasound;34
1.6.1.3;Intra-Articular Injections;35
1.6.1.4;Trigger Point and Muscular Injections;35
1.6.1.5;Zygapophyseal and Medial Branch Blocks;35
1.6.1.6;Epidural Blocks;36
1.6.1.7;Sympathetic Blocks;36
1.6.1.8;Combined US and CT/Fluoroscopy;37
1.6.2;Conclusion;37
1.6.3;References;38
1.7;2: Basics of Ultrasound Imaging;40
1.7.1;Introduction;40
1.7.2;Basic Principles of B-Mode US;41
1.7.3;Generation of Ultrasound Pulses;41
1.7.4;Ultrasound Wavelength and Frequency;41
1.7.5;Ultrasound–Tissue Interaction;42
1.7.6;Recent Innovations in B-Mode Ultrasound;45
1.7.7;Conclusion;46
1.7.8;References;46
1.8;3: Essential Knobology for Ultrasound-Guided Regional Anesthesia and Interventional Pain Management;47
1.8.1;Introduction;48
1.8.2;Frequency and Probe Selection;48
1.8.3;Depth;49
1.8.4;Gain;51
1.8.5;Time Gain Compensation;52
1.8.6;Focus;52
1.8.7;Presets;54
1.8.8;Color Doppler;55
1.8.9;Power Doppler;56
1.8.10;Compound Imaging;57
1.8.11;Tissue Harmonic Imaging;58
1.8.12;Optimization Button;58
1.8.13;Freeze Button and Image Acquisition;59
1.8.14;References;59
1.9;4: How to Improve Needle Visibility;60
1.9.1;Introduction;61
1.9.2;Training and Phantom Simulation;61
1.9.2.1;Training with Adequate Mentorship;61
1.9.2.2;Phantoms;62
1.9.2.3;High-Fidelity Simulation;63
1.9.2.4;Combined Ultrasound and Flouroscopic Phantom Simulators;64
1.9.3;Procedural Needle-Related Visibility Factors;67
1.9.3.1;Basic Sonography and Needle Image Interpretation;67
1.9.3.2;Acoustic Impedance as the Basis for Procedure Needle Visualization;68
1.9.3.3;Size (Gauge) of the Procedure Needle and Its Echogenicity;68
1.9.3.4;The Skin Insertion Site Selected and Angle of Procedure Needle Passage;68
1.9.3.5;Echogenic Procedure Needles;70
1.9.3.6;Procedure Needle Tip;72
1.9.4;The Ultrasound Device and Procedure Needle Visibility;76
1.9.4.1;Ultrasound Imaging Artifacts and Procedure Needle Visibility;76
1.9.4.2;Impact of Various Sonographic Modes on Procedure Needle Visibility;77
1.9.4.2.1;Compound Spatial and Frequency Image Reconstruction Following Acoustic Beam Steering and Variable Frequency;77
1.9.4.2.2;Frequency of the Ultrasound Probe (AKA Depth) Acoustic Power and Gain;78
1.9.4.2.3;Time Gain Compensation and Harmonic Imaging;79
1.9.4.2.4;Brightness, Motion, and Doppler Modes;79
1.9.4.2.5;3D and 4D Ultrasound Imaging;79
1.9.4.3;Recent Advances in Ultrasound Imaging and Procedure Needle Visibility;82
1.9.5;Needle-Probe Alignment;83
1.9.5.1;Need for Procedure Needle and Ultrasound Probe Alignment;83
1.9.5.2;“In-Plane” and “Out-of-Plane” Needle Approach: Classical Probe-Needle Interpositions;83
1.9.5.3;Oblique Plane Needle Approach for Ultrasound-Guided Pain Management;85
1.9.5.4;Biplane Needle Imaging Approach for Ultrasound-Guided Pain Management;86
1.9.5.5;Mechanical and Optical Procedure Needle Guides;86
1.9.5.6;Advanced Procedure Needle Positioning Systems;87
1.9.5.7;The “ART” of Scanning for Better Procedure Needle Visualization;89
1.9.5.8;Ergonomics for Better Procedure Needle Visibility;90
1.9.6;Enhancement and Techniques to Improve Procedure Needle Localization;91
1.9.6.1;Basic Sonographic Effect of Enhancement;91
1.9.6.2;Enhancement with Priming, Insertion of Stylet or Guide Wire, and Vibration;92
1.9.6.3;Hydrolocalization of the Procedure Needle;93
1.9.6.4;Procedure Needle Visibility by Agitated Solutions or with Ultrasound Contrast Agents;94
1.9.6.5;Localization of the Procedure Needle Tip with the Aid of Nerve Stimulation;96
1.9.7;Summary;96
1.9.8;References;97
1.10;5: Spine Anatomy and Sonoanatomy for Pain Physicians;102
1.10.1;Introduction;103
1.10.2;Basic Spine Anatomy (Figures 5.1–5.13);103
1.10.2.1;Cervical Spine;103
1.10.2.2;Thoracic Spine;106
1.10.2.3;Lumbar Spine;107
1.10.2.4;Sacrum;110
1.10.3;Sonoanatomy of the Cervical Spine;113
1.10.3.1;Superficial (Figures 5.14–5.21);113
1.10.3.2;Deep (Figures 5.22–5.25);117
1.10.4;Sonoanatomy of the Thoracic Spine;119
1.10.4.1;Superficial (Figures 5.26 and 5.27);119
1.10.4.2;Deep (Figures 5.28 and 5.29);121
1.10.5;Sonoanatomy of the Lumbar Spine;122
1.10.5.1;Superficial (Figures .5.30–5.33);122
1.10.5.2;Deep (Figures 5.34–5.36);124
1.10.6;Sonoanatomy of the Sacrum and Sacroiliac Joint;126
1.10.6.1;Superficial (Figures 5.37–5.40);126
1.10.6.2;Deep (Figures 5.41 and 5.42);127
1.11;6: Ultrasound-Guided Third Occipital Nerve and Cervical Medial Branch Nerve Blocks;129
1.11.1;Anatomy;129
1.11.2;Indications for Cervical Medial Branch Block;130
1.11.3;Why Ultrasound-Guided Facet Nerve Block? The Literature and Our Experience;131
1.11.3.1;Possible Advantages of Ultrasound for Cervical Facet Nerve Blocks;132
1.11.3.2;Limitations of Ultrasound;132
1.11.4;Ultrasound-Guided Technique for TON and Cervical Medial Branch Block;132
1.11.4.1;Scanning Before Injection;132
1.11.4.2;Identifying the Correct Level: Method 1;132
1.11.4.3;Identifying the correct Level: Method 2;136
1.11.4.4;Practical Performance of Block;136
1.11.5;Conclusion;138
1.11.6;References;138
1.12;7: Ultrasound-Guided Cervical Zygapophyseal (Facet) Intra-Articular Injection;140
1.12.1;Anatomy of the Cervical Facet Joints;140
1.12.1.1;Indications for Cervical Zygapophyseal Joint Intra-Articular Injection;141
1.12.1.2;Literature Review of Ultrasound-Guided Cervical Facet Injections;141
1.12.1.3;Ultrasound-Guided Technique for Cervical Facet Intra-Articular Injection;141
1.12.1.3.1;Lateral Approach;141
1.12.1.3.2;Posterior Approach;141
1.12.2;References;143
1.13;8: Ultrasound-Guided Cervical Nerve Root Block;145
1.13.1;Anatomy of Cervical Nerve Root;145
1.13.1.1;Indications;146
1.13.1.2;Limitations of the Fluoroscopy-Guided Techniques;146
1.13.1.3;Literature Review of Ultrasound-Guided Cervical Nerve Root Block;146
1.13.1.4;Sonoanatomy of the Cervical Spine and Identification of the Cervical Level;147
1.13.1.5;Ultrasound-Guided Technique for Cervical Selective Nerve Root Block;148
1.13.2;References;150
1.14;9: Ultrasound-Guided Thoracic Paravertebral Block;152
1.14.1;Introduction;153
1.14.2;Anatomy;153
1.14.3;Mechanism of Blockade;155
1.14.4;Techniques of TPVB;155
1.14.5;Ultrasound-Guided TPVB;156
1.14.6;Sonoanatomy Relevant for TPVB;157
1.14.6.1;Basic Considerations;157
1.14.6.2;Transverse Scan of the Thoracic Paravertebral Region;158
1.14.6.3;Sagittal Scan of the Thoracic Paravertebral Region;160
1.14.7;Techniques of USG TPVB;163
1.14.7.1;Transverse Scan with Short-Axis Needle Insertion (Technique 1);163
1.14.7.2;Paramedian Oblique Sagittal Scan with In-Plane Needle Insertion (Technique 2);163
1.14.7.3;Transverse Scan with In-Plane Needle Insertion or the Intercostal Approach to the TPVS (Technique 3);164
1.14.8;Conclusion;165
1.14.9;References;166
1.15;10: Ultrasound-Guided Lumbar Zygapophysial (Facet) Nerve Block;168
1.15.1;Introduction;168
1.15.2;Anatomy;169
1.15.3;Literature Review;169
1.15.4;Scanning Technique;170
1.15.5;Injection Technique;173
1.15.5.1;Lumbar (L1–L4) Zygapophysial Medial Branch and L5 Dorsal Ramus Nerve Block;173
1.15.5.2;Limitations of Ultrasound-Guided Zygapophysial Nerve and Joint Injection;175
1.15.6;References;175
1.16;11: Ultrasound-Guided Lumbar Nerve Root (Periradicular) Injections;176
1.16.1;Introduction;176
1.16.2;Ultrasound-Guided Technique;177
1.16.3;Limitations of the Ultrasound-Guided Technique;177
1.16.4;References;178
1.17;12: Ultrasound-Guided Central Neuraxial Blocks;180
1.17.1;Introduction;181
1.17.2;History;181
1.17.3;Ultrasound Imaging of the Spine;182
1.17.3.1;Basic Considerations;182
1.17.3.2;Axis of Scan;182
1.17.3.3;Spinal Sonoanatomy;183
1.17.3.4;The Water-Based Spine Phantom;184
1.17.3.5;Ultrasound Imaging of the Sacrum;184
1.17.3.6;Ultrasound Imaging of the Lumbar Spine;187
1.17.3.7;Ultrasound Imaging of the Thoracic Spine;189
1.17.4;Ultrasound-Guided CNB;190
1.17.4.1;Caudal Epidural Injection;191
1.17.4.2;Lumbar Epidural Injection;192
1.17.4.3;Thoracic Epidural Injection;193
1.17.4.4;Spinal Injection;194
1.17.5;The Evidence;194
1.17.6;Education and Training;194
1.17.7;Conclusion;195
1.17.8;References;196
1.18;13: Ultrasound-Guided Caudal, Ganglion Impar, and Sacroiliac Joint Injections;198
1.18.1;Ultrasound-Guided Caudal Epidural Injections;199
1.18.1.1;Anatomy;199
1.18.1.2;Indications for Caudal Epidural Injection;199
1.18.1.3;Limitations of the Landmark “Blind” Technique;199
1.18.1.4;Literature Review of Ultrasound-Guided Caudal Epidural Injections;199
1.18.1.5;Ultrasound-Guided Caudal Injection Is Better than the “Blind” Technique;200
1.18.1.6;Ultrasound-Guided Technique for Caudal Epidural Injection;200
1.18.1.7;Limitations of the Ultrasound-Guided Technique;201
1.18.2;Ultrasound-Guided Ganglion Impar Block;202
1.18.2.1;Anatomy;202
1.18.2.2;Indications;202
1.18.2.3;Limitations of the Current Technique;202
1.18.2.4;Literature Review on Ultrasound-Guided Ganglion Impar Block;203
1.18.2.5;Technique of Ultrasound-Guided Ganglion Impar Block;203
1.18.2.6;Limitations of the Ultrasound-Guided Technique;204
1.18.3;Ultrasound-Guided Sacroiliac Joint Injection;204
1.18.3.1;Anatomy;204
1.18.3.2;Indications for SIJ Injection;205
1.18.3.3;Literature Review on Ultrasound-Guided SIJ Injection;205
1.18.3.4;Technique of Ultrasound-Guided SIJ Injection;205
1.18.3.5;Limitations of Ultrasound-Guided SIJ Injection;205
1.18.4;References;207
1.19;14: Ultrasound-Guided Transversus Abdominis Plane (TAP) Block;210
1.19.1;Introduction;210
1.19.2;Anatomy;211
1.19.2.1;The Classic Approach;211
1.19.2.2;Ultrasound-Guided Technique;212
1.19.3;Summary;213
1.19.4;References;214
1.20;15: Ultrasound-Guided Celiac Plexus Block and Neurolysis;215
1.20.1;Introduction;215
1.20.2;Anatomy of the Celiac Plexus;216
1.20.3;Current Techniques for Celiac Plexus Block;216
1.20.3.1;The Anterior Percutaneous Approach;217
1.20.3.1.1;Advantages of US-Guided Anterior Approach;218
1.20.3.1.2;Limitations of US-Guided Anterior Approach;218
1.20.3.2;Sonoanatomy of the Epigastrium and Relevant Structures;218
1.20.3.3;Percutaneous Ultrasound-Guided Celiac Plexus Block Technique;219
1.20.4;References;222
1.21;16: Ultrasound-Guided Blocks for Pelvic Pain;223
1.21.1;Introduction;224
1.21.2;Ilioinguinal, Iliohypogastric, and Genitofemoral Nerves;224
1.21.2.1;Anatomy;225
1.21.2.2;Literature Review on the Injection Techniques for Ilioinguinal, Iliohypogastric, and Genitofemoral Nerve Block;226
1.21.2.3;Ultrasound-Guided Technique of Ilioinguinal, Iliohypogastric,and Genitofemoral Nerve;227
1.21.2.3.1;Ilioinguinal and Iliohypogastric Nerves;227
1.21.2.3.2;Genital Branch of Genitofemoral Nerve;228
1.21.3;Piriformis Syndrome;230
1.21.3.1;Anatomy;231
1.21.3.2;Literature Review on Piriformis Muscle Injections;232
1.21.3.3;Ultrasound-Guided Technique for Piriformis Muscle Injection;233
1.21.4;Pudendal Neuralgia;234
1.21.4.1;Anatomy;234
1.21.4.2;Literature Review on the Pudendal Nerve Injections;235
1.21.4.3;Ultrasound-Guided Technique for Pudendal Nerve Injection;236
1.21.5;Conclusion;237
1.21.6;References;237
1.22;17: Ultrasound-Guided Nerve Blocks of the Upper Extremity;242
1.22.1;Introduction;243
1.22.1.1;Brachial Plexus Anatomy;243
1.22.2;Interscalene Block;244
1.22.2.1;Anatomy;244
1.22.2.2;Indication;244
1.22.2.3;Procedure;244
1.22.3;Supraclavicular Block;245
1.22.3.1;Anatomy;245
1.22.3.2;Indication;245
1.22.3.3;Procedure;245
1.22.4;Infraclavicular Block;247
1.22.4.1;Anatomy;247
1.22.4.2;Indication;247
1.22.4.3;Procedure;247
1.22.5;Axillary Block;248
1.22.5.1;Anatomy;248
1.22.5.2;Indication;248
1.22.5.3;Procedure;249
1.22.6;Distal Peripheral Nerves in the Upper Extremity;249
1.22.7;Summary;251
1.22.8;References;251
1.23;18: Ultrasound-Guided Nerve Blocks of the Lower Limb;253
1.23.1;General Considerations;254
1.23.2;Femoral Nerve Block;255
1.23.2.1;Clinical Application;255
1.23.2.2;Anatomy (Figures .18.3 and .18.4);255
1.23.2.3;Preparation and Positioning;255
1.23.2.4;Ultrasound Technique;256
1.23.2.4.1;Single-Injection Technique;257
1.23.2.4.2;Continuous Catheter Technique;258
1.23.3;Sciatic Nerve Block;258
1.23.3.1;Clinical Application;258
1.23.3.2;Anatomy;258
1.23.3.3;Preparation and Positioning;258
1.23.3.4;Ultrasound Technique;259
1.23.4;Sciatic Nerve Blockade in the Popliteal Fossa;260
1.23.4.1;Clinical Application;260
1.23.4.2;Anatomy;260
1.23.4.3;Preparation and Positioning;261
1.23.4.4;Ultrasound Technique;261
1.23.5;Lumbar Plexus Block;262
1.23.5.1;Clinical Application;262
1.23.5.2;Anatomy;262
1.23.5.3;Preparation and Positioning;263
1.23.5.4;Ultrasound Technique;263
1.23.6;Obturator Nerve Block;264
1.23.6.1;Clinical Application;264
1.23.6.2;Anatomy;264
1.23.6.3;Preparation and Positioning;265
1.23.6.4;Ultrasound Technique;265
1.23.7;Lateral Femoral Cutaneous Nerve Block;266
1.23.7.1;Clinical Application;266
1.23.7.2;Anatomy;266
1.23.7.3;Preparation and Positioning;266
1.23.7.4;Ultrasound Technique;267
1.23.8;Saphenous Nerve Block;267
1.23.8.1;Clinical Application;267
1.23.8.2;Anatomy;267
1.23.8.3;Preparation and Positioning;268
1.23.8.4;Ultrasound Technique;268
1.23.9;Ankle Block;269
1.23.9.1;Clinical Application;269
1.23.9.2;Anatomy;269
1.23.9.3;Preparation and Positioning;270
1.23.9.4;Ultrasound Technique;270
1.23.9.4.1;Posterior Tibial Nerve Block;271
1.23.9.4.2;Deep Peroneal Nerve Block;271
1.23.10;References;272
1.24;19: Ultrasound-Guided Continuous Peripheral Nerve Blocks;273
1.24.1;Introduction;274
1.24.1.1;Applications;274
1.24.2;Overview of Ultrasound-Guided Perineural Catheter Insertion;274
1.24.2.1;Nerve in Short Axis, Needle In-Plane Approach (Figure 19.1);274
1.24.2.2;Nerve in Short Axis, Needle Out-of-Plane (Figure 19.2);275
1.24.2.3;Nerve in Long Axis, Needle In-Plane;275
1.24.3;Preparation for Ultrasound-Guided Perineural Catheter Insertion;276
1.24.3.1;Sterile Technique;276
1.24.3.2;Standard Perineural Catheter Equipment;276
1.24.4;Ultrasound-Guided Perineural Catheter Insertion Techniques for Common Surgical Procedures;277
1.24.4.1;Interscalene CPNB;277
1.24.4.2;Infraclavicular CPNB;278
1.24.4.3;Femoral CPNB;278
1.24.4.4;Subgluteal Sciatic CPNB;279
1.24.4.5;Popliteal Sciatic CPNB;281
1.24.4.6;Tranversus Abdominis Plane CPNB;282
1.24.5;Conclusion;282
1.24.6;References;283
1.25;20: Ultrasound-Guided Cervical Sympathetic Block;287
1.25.1;Introduction;287
1.25.2;Anatomy;288
1.25.3;Existing Techniques;288
1.25.4;Technique for Ultrasound-Guided Injection;290
1.25.5;References;292
1.26;21: Ultrasound-Guided Peripheral Nerve Blockade in Chronic Pain Management;293
1.26.1;Introduction;294
1.26.2;Lateral Femoral Cutaneous Nerve Block;294
1.26.2.1;Anatomy;294
1.26.2.2;Literature Review of Injection Techniques;295
1.26.2.3;Ultrasound-Guided Block Technique;295
1.26.3;Suprascapular Nerve Block;296
1.26.3.1;Anatomy;296
1.26.3.2;Literature Review of Injection Techniques;297
1.26.3.3;Ultrasound-Guided Block Technique;299
1.26.4;Intercostal Nerve Block;299
1.26.4.1;Anatomy;300
1.26.4.2;Literature Review of Injection Techniques;300
1.26.4.3;Ultrasound-Guided Block Technique;301
1.26.5;Conclusion;303
1.26.6;References;303
1.27;22: Ultrasound-Guided Shoulder Joint and Bursa Injections;306
1.27.1;Introduction;307
1.27.2;Subacromial/Subdeltoid Bursa;308
1.27.2.1;Anatomy;308
1.27.2.2;Clinical Presentation;308
1.27.2.3;Limitations of the Blind Approach;308
1.27.2.4;Ultrasound-Guided Technique;308
1.27.3;Biceps Tendon Sheath (Biceps – Long Head);310
1.27.3.1;Anatomy;310
1.27.3.2;Clinical Presentation;310
1.27.3.3;Ultrasound-Guided Technique;310
1.27.4;Acromio-Clavicular Joint;311
1.27.4.1;Anatomy;311
1.27.4.2;Clinical Presentation;312
1.27.4.3;Ultrasound-Guided Technique;312
1.27.5;Glenohumeral Joint;312
1.27.5.1;Anatomy;312
1.27.5.2;Clinical Presentation;313
1.27.5.3;Limitations of the Blind Approach;314
1.27.5.4;Ultrasound-Guided Technique;314
1.27.5.5;The Rotator Interval Approach;314
1.27.6;Subscapularis Tendon/Subscapularis Bursa;316
1.27.6.1;Anatomy;316
1.27.6.2;Clinical Presentation;316
1.27.6.3;Ultrasound-Guided Technique;316
1.27.7;Sternoclavicular Joint;317
1.27.7.1;Anatomy;317
1.27.7.2;Clinical Presentation;317
1.27.7.3;Ultrasound-Guided Technique;318
1.27.8;Conclusion;318
1.27.9;References;319
1.28;23: Ultrasound-Guided Hand, Wrist, and Elbow Injections;320
1.28.1;Introduction;321
1.28.2;Ultrasound-Guided Carpal Tunnel Injections;321
1.28.2.1;Anatomy;321
1.28.2.2;Literature Review on Ultrasound-Guided Carpal Tunnel Injections;322
1.28.2.3;Ultrasound-Guided Technique for Carpal Tunnel Injection;323
1.28.3;Ultrasound-Guided Trigger Finger Injections;324
1.28.3.1;Anatomy;324
1.28.3.2;Literature Review on Ultrasound-Guided Trigger Finger Injections;324
1.28.3.3;Ultrasound-Guided Trigger Finger Injection Technique;324
1.28.4;Ultrasound-Guided Wrist Injections;325
1.28.4.1;Anatomy;325
1.28.4.2;Literature Review on Ultrasound-Guided Wrist Injections;326
1.28.4.3;Ultrasound-Guided Technique for Wrist Injections;327
1.28.5;Ultrasound-Guided Injections for Tendon Dysfunction;329
1.28.5.1;Anatomy;329
1.28.5.1.1;de Quervain’s Tenosynovitis;329
1.28.5.1.2;Intersection Syndrome;329
1.28.5.1.3;Lateral Epicondylitis;329
1.28.5.1.4;Tendon Impingement;330
1.28.5.2;Ultrasound-Guided Technique for Tendon Dysfunction;330
1.28.6;Ultrasound-Guided Elbow Injections;332
1.28.6.1;Anatomy;332
1.28.6.2;Literature Review on Ultrasound-Guided Elbow Injections;332
1.28.6.3;Ultrasound-Guided Elbow Injection Technique;333
1.28.7;References;334
1.29;24: Ultrasound-Guided Hip Injections;337
1.29.1;Introduction;337
1.29.2;Anatomy of the Hip Joint;338
1.29.3;Intra-Articular Hip Injections;338
1.29.4;Limitations of the Blind Technique;338
1.29.5;Evidence for Ultrasound-Guided Hip Injections;339
1.29.6;Technique of Ultrasound-Guided Hip Injections;339
1.29.7;Conclusion;341
1.29.8;References;341
1.30;25: Ultrasound-Guided Knee Injections;343
1.30.1;Introduction;343
1.30.2;Limitations of the Current Surface Landmarks Technique;343
1.30.3;Technique for Ultrasound-Guided Knee Joint Injection;344
1.30.4;Conclusion;346
1.30.5;References;346
1.31;26: Ultrasound-Guided Peripheral Nerve Stimulation;348
1.31.1;Introduction;348
1.31.2;Current Evidence;349
1.31.3;Patient Selection and Role of Neurolysis;350
1.31.4;Anatomical Considerations;350
1.31.5;Radial Nerve Stimulation;350
1.31.6;Ulnar Nerve;351
1.31.7;Median Nerve;351
1.31.8;Sciatic Nerve at Popliteal Bifurcation;352
1.31.9;Posterior Tibial Nerve;354
1.31.10;Conclusion;354
1.31.11;References;354
1.32;27: Ultrasound-Guided Occipital Stimulation;355
1.32.1;Introduction;355
1.32.2;Limitations of the Current ONS Technique;356
1.32.3;Anatomy of the GON;356
1.32.4;Occipital Field Stimulation vs. Peripheral Nerve Stimulation;357
1.32.5;Technique of US-Guided ONS Lead Implant;357
1.32.6;References;358
1.33;28: Ultrasound-Guided Groin Stimulation;359
1.33.1;Introduction;359
1.33.2;Limitations of the Current Technique;360
1.33.3;Anatomy of the Ilioinguinal and Iliohypogastric Nerves;360
1.33.4;Groin Field Stimulation vs. Peripheral Nerve Stimulation;360
1.33.5;Technique of Ultrasound-Guided IL/IH PNS Lead Implant;360
1.33.6;Reference;362
1.34;29: Ultrasound-Guided Atlanto-Axial and Atlanto-Occipital Joint Injections;363
1.34.1;Introduction;363
1.34.2;Anatomy of the Atlanto-Axial and Atlanto-Occipital Joints;364
1.34.3;Ultrasound-Guided Atlanto-Axial and Atlanto-Occipital Joint Injection Technique;364
1.34.4;References;367
1.35;30: Ultrasound-Assisted Cervical Diskography and Intradiskal Procedures;368
1.35.1;Introduction;368
1.35.2;Limitations of the Fluoroscopically Guided Cervical Diskography;369
1.35.3;Technique of Ultrasound-Assisted Cervical Diskography;369
1.35.4;References;371
1.36;Index;372