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“Scarring Triangle” (L5-S1) Technique

Dr. Eleni Episkopou on January 31, 2017 at 2:36 pm
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    • Eleni EpiskopouDr. Eleni Episkopou
      Participant
      Joined: Nov 25, 2015
      Posts: 2
      #5275

      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

      • Gabor B RaczGabor B Racz
        Participant
        Joined: Mar 28, 2016
        Posts: 30
        #5276

        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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