Annals of Rehabilitation Medicine

Feasibility of Ultrasound Guided Atlanto-occipital Joint Injection: Sun Jae Won, U-Young Lee, Sei Un Cho, Won Ihl Rhee; Ann Rehabil Med 2012;36(5):627-632. Published online October 31, 2012; DOI: https://doi.org/10.5535/arm.2012.36.5.627

Abstract
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Objective

To evaluate the feasibility of ultrasound guided atlanto-occipital joint injection.

Method

Six atlanto-occipital joints of three cadavers were examined. Cadavers were placed in prone position with their head slightly rotated towards the contra-lateral side. The atlanto-occipital joint was initially identified with a longitudinal ultrasound scan at the midline between occipital protuberance and mastoid process. Contrast media 0.5cc was injected into the atlanto-occipital joint using an in-plane needle approach under ultrasound guide. The location of the needle tip and spreading pattern of the contrast was confirmed by fluoroscopic evaluation.

Results

After ultrasound guided atlanto-occipital joint injection, spreading of the contrast media into the joint was seen in all the injected joints in the anterior-posterior fluoroscopic view.

Conclusion

The ultrasound guided atlanto-occipital injection is feasible. The ultrasound guided injection by Doppler examination can provide a safer approach to the atlanto-occipital joint.

Citations

Citations to this article as recorded by

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Suggestion of Safer and Easier Technique of Suprascapular Nerve Block based on Cadaver Study.: Hong, Hyun taek , Lee, Jong In , Lee, Won Il , Kim, Joon Sung , Sung, Nam Suk , Choi, Hang Joon , Won, Sun Jae , Ko, Young Jin; J Korean Acad Rehabil Med 2005;29(6):630-634.

Abstract
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Objective
To suggest a safer and easier technique of suprascapular nerve block by assessing anatomical relationship of the suprascapular notch from a view point of surface anatomy. Method: Fourteen shoulders of seven cadavers were dissected in prone position. The scapular notch was exposed and the articular branch of suprascapular nerve was observed. The length and depth of spine, height and relative position of scapular notch were measured for all of the specimen. Results: The length of the spine was 11.45⁑0.72 cm. The injection point was measured as relative position of scapular notch on the spine. The ratio between distance from medial border of the spine to injection point and from the injection point to posterior angle of acromion was 1.89⁑0.2：1. The depth of the spine, which was defined as the shortest vertical distance from the injection point to the scapula was 2.69⁑0.43 cm, and the vertical distance from this contact point to the base of the scapular notch, e.g. the height of the scapular notch, was 1.18⁑0.1 cm. Conclusion: We expect we could perform suprascapular nerve block easily and safely with suggested surface landmarks and measured data in this study. (J Korean Acad Rehab Med 2005; 29: 630-634)

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A Cadaver Study of Iliolumbar Ligament from a Viewpoint of Surface Anatomy.: Kim, Joon Sung , Kim, Hye Won , Kim, Jong Hyun , Kim, Il Soo , Ko, Young Jin , Shin, Jae Eun , Kang, Eu Jin; J Korean Acad Rehabil Med 2003;27(6):974-977.

Abstract
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Objective: To assess the anatomical relationship between spinous process of the lumbar vertebrae and iliolumbar ligament from a viewpoint of surface anatomy.

Method: Fourteen iliolumbar ligaments of seven human cadavers were dissected and measured distance from the lumbar spinous process to the iliolumbar ligament and vertical depth of iliolumbar ligament from the skin surface.

Results: All 14 iliolumbar ligaments were originated at the L5 transverse process and inserted in anterior surface of the iliac crest. Direct distance from lumbar spinous process to the origin siteof the iliolumbar ligament was 7.67⁑0.39 cm (distance from the spinous process to presumed skin point of the termination site of the ligament, 6.71⁑0.4 cm). Vertical depth from skin surface was 3.94⁑0.57 cm to the origin site of the iliolumbar ligament, and 3.67⁑0.54 cm to the termination site of the iliolumbar ligament.

Conclusion: The iliolumbar ligament was deep seated anatomical structure in the lumbosacral region. Superficial landmark of the lumbar spinous process may be useful in approach to iliolumbar ligament. (J Korean Acad Rehab Med 2003; 27: 974-977)