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equipment
Needle & Equipment Selection by Procedure
| Procedure | Needle Type | Gauge | Length | Key Notes |
|---|---|---|---|---|
| Lumbar TFESI | Spinal (Quincke) | 22-25G | 3.5" (90mm) | Slight bend at distal tip for steering. Use microbore extension tubing. |
| S1 TFESI | Spinal (Quincke) | 22-25G | 3.5" (90mm) | Through posterior sacral foramen. Arcuate line of Aprill is the landmark. |
| Cervical TFESI | Spinal (Quincke) | 22-25G | 2.5-3.5" | Smaller gauge mandatory. DEXAMETHASONE ONLY (non-particulate). |
| Interlaminar ESI | Tuohy (epidural) | 17-20G | 3.5" | Loss-of-resistance technique. Tuohy bevel directs catheter cephalad if used. |
| Caudal ESI | Spinal (Quincke) | 20-22G | 3.5" | Enter through sacral hiatus. Do not advance past S2 (thecal sac termination). |
| Medial Branch Block | Spinal (Quincke) | 22-25G | 3.5" | Target: SAP/TP junction. Small volume (0.25-0.5 mL per target). |
| Lumbar RFA | RF Cannula | 16-18G (cannula), 20G (active tip) | 10cm, 10mm active tip | Electrode PARALLEL to nerve. 80°C x 60-90 sec. Use 18G introducer. |
| Cervical RFA | RF Cannula | 18-20G | 5-10cm, 6-10mm active tip | Cannula must NOT pass anterior margin of articular pillar. |
| SI Joint Injection | Spinal (Quincke) | 22-25G | 3.5" | Inferior aspect of joint. Arthrogram confirms intra-articular placement. |
| SI Joint RFA (Cooled) | Cooled RF Probe | 17G introducer | Per manufacturer | Clockface targets: S1/S2 at 2:30, 4:00, 5:30; S3 at 2:30, 4:00. |
| C1-2 Joint Injection | Spinal (Quincke) | 22-25G | 2.5-3.5" | Target: lateral 1/3 of joint. DEXAMETHASONE ONLY. Risk: VA, C2 DRG. |
| BVN Ablation (Intracept) | Curved introducer + RF probe | Per Intracept system | Transpedicular | 85°C x 15 min or 75°C x 7 min. Target: 30-50% depth at midline. |
| SCS Trial Lead | Tuohy (epidural) | 14G | Per manufacturer | Percutaneous cylindrical lead through Tuohy. Fluoro confirms T8-10 placement. |
Notes
- 1. Always use microbore extension tubing for all injections to reduce movement artifact during injection
- 2. Quincke needle: cutting bevel. Tuohy: blunt, curved bevel directing catheter/lead
- 3. For all procedures: verify needle gauge is compatible with the planned injectate viscosity
Source: IPSIS Technical Manual, SIS Practice Guidelines | Updated: 2026-04-03
Printed from Interventional Pain Trainer | Needle & Equipment Selection by Procedure | 2026-04-03