# L5,S1,S2,S3 root blocks?



## BFAITHFUL (Aug 15, 2010)

64483-rt, 64484-rt  or 64483-rt, 64484-rtx3

DX:  right sacroilitis   720.2

patient presents for the root block at L5, S1, S2 and S3 on the right side.  A 900 fluorosocpe was brought in the AP view of lumbosacral spine was obtained.  A 2.5 inch 22 gauge spinal quincke needle was then advanced through the skin wheal and guided towards the iliac crest until the contact of the bone.  aspirations were negative and there was no paresthesia.  the needle was injected with 0.5ml of omnipaque 240.  the resulting dye distribution did not reveal intravascular dye distribution.  At the pint, the S1, S2 and S3 foramina on the right side were opened maximally with various degrees of C-arm until the 3 o'clock positions of the foramina were marked and the skin over the mark was injected with 3ml of 1% lidocaine through 25 gauge skin needles and the skin wheals were raised.  A 3.5 inch 22 gauge spinal quincke needles were advanced through the skin wheal and guided towards lateral margin of the S1, S2 and S3 foramina at 3 o'clock position until they contract the bone.  aspirations were negative and there was no paresthesia.  a 1ml of omnipaque 240 was injected at each level.   the needles were then injected with 1ml of .25% bupivacaine per level.  the needles were removed and antibiotic ointment applied .  

thank you!


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## raghavendra.pawar (Aug 16, 2010)

The document supports for 64483, 64484 x 2 for S1, S2, and S3, as per the question it should be 64483, 64484 x 3

hope this helps


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