(a) patient positioning, (b) puncture, (c) lignocaine injection, (d) correct needle position.
Indication: Low back pain in a case of spondylolysis and degenerative disc disease. Injection of lignocaine at the level of the isthmic lysis sedates low back pain if related to the spondylolysis. When test infiltration is positive, surgical isthmic reconstrution may be discussed

Target: Isthmic lysis, most of at the L5 level

Procedure:

  • - Patient is placed prone on the CT table
  • - Axial scan (generally at the lower two lumbar levels) to locate the spondylolysis
  • - Posterolateral approach
  • - CT fluoroscopy-guided direct puncture from skin to the isthmic lysis with a 22 G needle
  • - Injection of 1-2 mL of Lignocaine (2%) inside the isthmic lysis
  • -After 5 minutes, patient should be painless in forced lumbar extension if pain is due to the spondylolysis

Danger: Easy procedure, without any particular risk