Cadaver study demonstrates no radiologic spread to Thoracic Paravertebral space after Transmuscular Quadratus Lumborum Block

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A radiologic and anatomic assessment of injectate spread following transmuscular quadratus lumborum block in cadavers.
Adhikary SD, El-Boghdadly K, Chin KJ et al.
Anaesthesia. 2016 Oct 12. doi: 10.1111/anae.13647.


The authors performed bilateral transmuscular quadratus lumborum blocks in six cadavers using iodinated contrast and
methylene blue. Computed tomography imaging was performed in four cadavers and anatomical dissection was completed
in five.
The authors demonstrated spread to the lumbar paravertebral space in 63% of specimens, laterally to the
transversus abdominis muscle in 50% and caudally to the anterior superior iliac spine in 63% of specimens.
There was no radiographic evidence of spread to the thoracic paravertebral space. Anatomical dissection revealed dye staining
of the upper branches of the lumbar plexus and the psoas major muscle in 70% of specimens.
No radiologic spread to Thoracic Paravertebral space
Further clinical studies are required to confirm if the quadratus lumborum block might be a suitable alternative to lumbar plexus


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