Researchers Offer Alternate Approach to Loss of Resistance Technique

Visual monitoring of the Tuohy needle tip under fluoroscopy can serve as an alternative approach for needle placement in spinal cord stimulator trials and implantation, according to an article published in Pain Physician.

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Traditionally, pain physicians utilized the “loss of resistance” technique under anteroposterior fluoroscopic guidance in order to ensure midline lead placement and appropriate entry into the epidural space. However, defects in or congenital underdevelopment of the ligamentum flavum can make it difficult for physicians to utilize this technique. A false loss of resistance may also occur.

The alternative method allows physicians to gauge needle depth as it enters into patients’ tissue and the epidural space, based on anatomic structural landmarks. It also allows multiple lead placement or single lead insertion multiple times in the same interlaminar space.

Read the study about loss of resistance.

Read other coverage about fluoroscopy:

4 Biggest Opportunities in Spine Surgery — From Spine Surgeon Dr. Jay Khanna of Johns Hopkins

Update: AMA Clarifies Fluoroscopy Coding Guidance

4 Changes to Pain Management Coding in 2011

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