3D nerve proximity mapping of the medial branch of lumbar dorsal ramus: An anatomical study

Lumbar medial branch (MB) radiofrequency ablation is a common intervention to treat facetogenic low back pain. Consensus among spine pain interventionalists is that the cannula tip should be placed adjacent to the periosteum of the lateral neck of the superior articular process (SAP) to ensure maximum contact with the MB. The spatial relationship of the nerve to the periosteum of the lateral neck of the SAP has not been quantified in 3D. The objectives of the current study were to: 1) use 3D modelling technology to quantify the location along the lateral neck of the SAP where the MB is in direct contact with the periosteum; and 2) identify target site(s) to optimize lumbar MB denervation.