{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:03:10Z","timestamp":1792004590339,"version":"4.4.0"},"reference-count":28,"publisher":"International Journal of Sports Physical Therapy","issue":"6","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Dry needling the lumbar multifidi is a technique used by physical therapists to effectively treat low back pain. While studies have examined the safety considerations in the upper lumbar spine related to the kidneys and lungs, none have investigated the possibility of entering the spinal canal in this region.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n The purpose of this cadaveric ultrasound-guided dry needling exploration was to determine if a dry needle can penetrate the ligamentum flavum at the T12\/L1 interspace and enter the spinal canal using a paramedian approach in a fresh-frozen, lightly fixed cadaver in the prone position.<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n Cadaveric study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The procedure was performed on a cadaver in the prone position. The needle was advanced under ultrasound guidance to determine if a 0.30 x 50 mm dry needle inserted 1.0 cm lateral to the spinous process of T12 and directed medially at a 22-degree angle could penetrate the ligamentum flavum and enter the spinal canal.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n As determined via ultrasound, a dry needle can penetrate the ligamentum flavum and enter the spinal canal at the thoracolumbar junction using this technique.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This interprofessional collaboration demonstrates that a dry needle can penetrate the ligamentum flavum to enter the spinal canal at T12\/L1 using a documented technique for dry needling the multifidus. A thorough understanding of human anatomy along with the incorporation of available technology, such as ultrasound, may decrease the risk of adverse events when dry needling the multifidi at the thoracolumbar junction.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n Level IV.<\/jats:p>\n <\/jats:sec>","DOI":"10.26603\/001c.89663","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T21:07:50Z","timestamp":1701378470000},"source":"Crossref","is-referenced-by-count":5,"title":["Safety Considerations When Dry Needling the Multifidi in the Thoracolumbar Region: A Cadaveric Study"],"prefix":"10.26603","volume":"18","author":[{"given":"Christi L.","family":"Williams","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033vjpd42","id-type":"ROR","asserted-by":"publisher"}],"name":"Belmont University","department":["Physical Therapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian R.","family":"Falyar","sequence":"additional","affiliation":[{"name":"Middle Tennessee School of Anesthesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan C.","family":"McConnell","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033vjpd42","id-type":"ROR","asserted-by":"publisher"}],"name":"Belmont University","department":["Physical Therapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Lindsley","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033vjpd42","id-type":"ROR","asserted-by":"publisher"}],"name":"Belmont University","department":["Physical Therapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11140","published-online":{"date-parts":[[2023,12,1]]},"reference":[{"issue":"2","key":"ref1","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3340\/jkns.2010.47.2.140","article-title":"Development of postdural puncture headache following therapeutic acupuncture using a long acupuncture needle","volume":"47","author":"Dae-Jean Jo","year":"2010","journal-title":"Journal of Korean Neurosurgical Society","ISSN":"https:\/\/id.crossref.org\/issn\/2005-3711","issn-type":"print"},{"issue":"3","key":"ref2","doi-asserted-by":"publisher","first-page":"314","DOI":"10.17085\/apm.2018.13.3.314","article-title":"Post-dural puncture headache following acupotomy using \"Wonli-acupuncture needle\" - A case report","volume":"13","author":"Hyungtae Kim","year":"2018","journal-title":"Anesthesia and Pain Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/2383-7977","issn-type":"print"},{"issue":"2","key":"ref3","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.jspd.2015.09.045","article-title":"Deep spine infection after acupuncture in the setting of spinal instrumentation","volume":"4","author":"Alexandra K. 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