“Scarring Triangle” (L5-S1) Technique
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Dear Dr. Racz,
Can I find the s1 foramen with the ultrasound that it is more easy especially in supine patient and the make flouro for the correct placement of the catheter ?
-Eleni Episkopou
MD -
Dear Dr.Episkopou,
I love your idea, just make sure when you aim the RX-2 Coude 18g go in and have the tip curve down. Then put the second stylet in to rotate cephalad.You need to aim slightly towards the middle as the ventral sacral foramen will lead the catheter into the pelvis. Remember the scarring triangle is the under the arm pit of the L5 nerve and lateral to the S1.
You are the first one that I shared my newly discovered information in patient who failed two lysis and artificial disk, four times S1’s scarring triangle catheters have given increasing duration pain relief, and sacral electrode.
A week ago I repeated the sacral S1 and a transforanimal L5-S1 Versa-Kath to mid canal followed by three time’s hypertonic saline injections since then he has driven 5 hours without pain and no recurrence of pain. The message is that there is the scarring triangle but also can extend to the lateral recess.Good Luck Proud of You for Thinking Let Me Know If you Have Any Questions
Gabor B. Racz, M.D, FIPP
Grover E. Murry Professor,
Professor Emeritus Chair TTUHSC
Ex-President World Institute of Pain
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