Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2024; 12(5): 1010-1017
Published online Feb 16, 2024. doi: 10.12998/wjcc.v12.i5.1010
Novel approach of ultrasound-guided lateral recess block for a patient with lateral recess stenosis: A case report
Jiao Yang, Xin-Ling Li, Qing-Bing Li
Jiao Yang, Xin-Ling Li, Qing-Bing Li, Department of Rehabilitation Medicine Center, West China Hospital, Chengdu 610041, Sichuan Province, China
Jiao Yang, Xin-Ling Li, Qing-Bing Li, Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Chengdu 610041, Sichuan Province, China
Author contributions: Li XL made substantial contributions to the study conception and design; Yang J was responsible for writing the original draft, reviewing, and editing; Li BQ contributed to the investigation and data curation; All authors approved the final version to be submitted.
Supported by the National Natural Science Foundation of China, No. 82305380; and The Postdoctoral Research Program, West China Hospital, Sichuan University, No. 2020HXBH018.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin Ling Li, PhD, Assistant Professor, Department of Rehabilitation Medicine Center, West China Hospital, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. lilingxinlsh@163.com
Received: November 24, 2023
Peer-review started: November 24, 2023
First decision: December 18, 2023
Revised: January 2, 2024
Accepted: January 15, 2024
Article in press: January 15, 2024
Published online: February 16, 2024
Processing time: 67 Days and 17.8 Hours
Abstract
BACKGROUND

Ultrasound guide technology, which can provide real-time visualization of the needle tip and tissues and avoid many adverse events, is widely used in minimally invasive therapy. However, the studies on ultrasound-guided Lateral recess block (LRB) are limited, this is probably because there is no recognized standard method for ultrasound scanning. This study aimed to evaluate the effect of ultrasound-guided LRB in patients with lateral recess stenosis (LRS).

CASE SUMMARY

A 65-year-old patient complained of low back pain accompanied occasionally by pain and numbness in the left lower limb. Physical examination showed tenderness on the spinous process and paraspinal muscles from L1 to S1, extensor hallucis longus and tibialis anterior weakness (muscle strength: 4−), and a positive straight leg raising test in the left lower limb (60°). Magnetic resonance imaging showed L4–L5 disc degeneration with left LRS and nerve root entrapment. Subsequently, the patient was diagnosed with LRS. This patient was treated with a novel ultrasound-guided LRB approach. The patient’s symptoms significantly improved without any complications at 1 wk postoperatively and at the 3-month follow-up.

CONCLUSION

This is the first report on the LRS treatment with ultrasound-guided LRB from the contralateral spinous process along the inner side of the articular process by out-plane technique. Further studies are expected to investigate the efficacy and safety of ultrasound-guided LRB for patients with LRS.

Keywords: Lateral recess stenosis; Ultrasound; Lateral recess block; Real-time visualization; Low back pain; Case report

Core Tip: Lateral recess block (LRB) is a common treatment method for lateral recess stenosis (LRS). However, it is an unsatisfactory method because of its high risk of side effects. Ultrasound-guided technology is widely used in minimally invasive therapy, but only a few studies have reported its use in LRB, this is probably because there is no recognized standard method for ultrasound scanning. In order to explore the standard method for ultrasound-guided LRB, we reported a novel ultrasound-guided LRB approach in treating a patient with LRS whose symptoms significantly improved without any complications.