Safety Considerations When Dry Needling the Multifidi in the Thoracolumbar Region: A Cadaveric Study.
Christi L Williams, Christian R Falyar, Ryan C McConnell and 1 others
PMID 38050548WHAT IT FOUND
A dry needle placed 1.0 cm lateral to the T12 spinous process at a 22-degree angle penetrated the ligamentum flavum and entered the spinal canal in a cadaver.
This suggests potential risk when needling the upper lumbar multifidi.
Key findings
01A 0.30 x 50 mm dry needle inserted 1.0 cm lateral to the T12 spinous process and angled 22 degrees medially penetrated the ligamentum flavum and entered the spinal canal.
02There is significant variability in described dry needling techniques for the multifidus, with many lacking specific angulation details, creating uncertainty about safety.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study used a single cadaver, so anatomical variations in living patients are not represented. The cadaver was embalmed, which may alter tissue resistance compared to living tissue. The study demonstrates anatomical possibility, not clinical incidence of adverse events. It does not prove that this specific technique causes harm in patients, only that the path exists.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret this as evidence that dry needling the multifidi is unsafe or that this technique causes injury in patients. It shows that in one cadaver, the spinal canal could be entered. Clinical adverse events are rare, but this highlights a specific anatomical risk zone at T12/L1.