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Fig. 1B —Long-axis injection technique for percutaneous sacroplasty. Coronal
oblique reconstruction of CT scan of normal sacrum from 25° right
posterior oblique projection directed along anteroposterior axis of left
sacroiliac joint (between large arrows). Posterosuperior iliac spine
(PSIS) covers mid portion of sacroiliac joint in this projection. Lateral
margins of left dorsal sacral foramina (white squares) may be
difficult to see using fluoroscopy but can be approximated using a line drawn
between center of S5 dorsal sacral foramen and geometric center of left L5-S1
facet joint (vertical line between asterisks). Needle
insertion site into sacrum is at midpoint between inferior margin of
sacroiliac joint and lateral margin of nearest dorsal foramen (usually S3 or
S4). Horizontal arrows outline lateral margins of right L5-S1 facet joint and
lateral margins of dorsal sacral neuroforamina, forming a smooth curve.
