Seems like many of my folks I’m seeing for neck or back pain have a hx of a prior fusion. I believe this was discussed at the course but I can’t recall exactly what was said. Are we ok to needle at the paravertebral level of the fusion? I realize it would be important to know if a laminectomy has also been done. My thought was to use a shorter needle. Any input would be appreciated.
Yes, you are safe to needle the paravertebral level in the cervical and lumbar spine with history of a spinal fusion. You are correct, in the event of a laminectomy, you would want to shorten the needle length. If the patient does not know the nature of their surgery, a shorter needle length is appropriate. Also, ENS would be a contraindication in these areas secondary to the hardware.