Fluoroscopically Guided Cervical Interlaminar Epidural Injections Using the Midline Approach: An Analysis of Epidurography Contrast Patterns

Kim, Kwang Su; Shin, Sung Sik; Kim, Tae Sam; Jeong, Chul; Yoon, Myung Ha; Choi, Jeong Il

doi:10.1213/ane.0b013e31819d107b

Cited by 32 publications

(33 citation statements)

References 8 publications

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“…However, these studies had some limitations. In some study, cervical lesions such as adhesions, HIVDs, and spinal stenosis were not described, although such lesions may affect the spread of contrast dye [15] . In another study, the injection site, which can also affect spread, was not uniform [16] .…”

Section: Discussionmentioning

confidence: 99%

“…[ 12 15 16 ] Yokoyama et al [12] showed that the contrast pattern is useful for predicting the distribution of local anesthetics. Other studies have shown that a 2 to 4 mL volume is adequate for contrast spread throughout the entire cervical epidural space, bilaterally.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have shown that a 2 to 4 mL volume is adequate for contrast spread throughout the entire cervical epidural space, bilaterally. [ 15 16 ] In 1 study, a 5 mL volume was found to be optimal for distribution to the lower cervical spine in degenerative cervical spinal diseases [14] . However, these studies had some limitations.…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 13–15 ] However, there is no consensus on the optimal volume of medication for cervical epidural steroid injections. There have been few studies on the relationship between the volume of solution and the cephalad spread of solution in CIEIs.…”

Section: Introductionmentioning

confidence: 99%

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Optimal volume of injectate for fluoroscopy-guided cervical interlaminar epidural injection in patients with neck and upper extremity pain

et al. 2016

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There is no study of optimal volume of contrast medium to use in cervical interlaminar epidural injections (CIEIs) for appropriate spread to target lesions. To determine optimal volume of contrast medium to use in CIEIs. We analyzed the records of 80 patients who had undergone CIEIs. Patients were divided into 3 groups according to the amount of contrast: 3, 4.5, and 6 mL. The spread of medium to the target level was analyzed. Numerical rating scale data were also analyzed. The dye had spread to a point above the target level in 15 (78.9%), 22 (84.6%), and 32 (91.4%) patients in groups 1 to 3, respectively. The dye reached both sides in 14 (73.7%), 18 (69.2%), and 23 (65.7%) patients, and reached the ventral epidural space in 15 (78.9%), 22 (84.6%), and 30 (85.7%) patients, respectively. There were no significant differences of contrast spread among the groups. There were no significant differences in the numerical rating scale scores among the groups during the 3 months. When performing CIEIs, 3 mL medication is sufficient volume for the treatment of neck and upper-extremity pain induced by lower cervical degenerative disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Optimal volume of injectate for fluoroscopy-guided cervical interlaminar epidural injection in patients with neck and upper extremity pain

et al. 2016

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“…Of concern to some is that interlaminar injections are often delivered at sites distal to the known pathology, reducing their target specificity. Still, some studies have shown that just 2 cc of contrast can spread from the lower cervical spine up to the C2 level [75,76]. In routine practice, compared to transforaminals, interlaminar epidurals involve larger injectate volumes containing less concentrated corticosteroids.…”

Section: Comparative Benefits and Risksmentioning

confidence: 99%

Cervical Foraminal Versus Interlaminar Epidurals: Risks, Benefits, and Alternatives

Smuck

Demirjian

Kennedy

2013

Curr Phys Med Rehabil Rep

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The goal of cervical epidural corticosteroid injections is to ameliorate pain from cervical radiculopathy. Controversy remains regarding the use and optimal delivery route of epidural medications in the cervical spine. The purpose of this review article is to compare the risks and benefits associated with cervical interlaminar and transforaminal epidural injections, and to describe alternatives to their use.

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Epidural catheter misplacement and knot formation within the hypoaxial musculature of a dog

Ferré¹,

Corletto²,

Shing³

et al. 2022

Vet Record Case Reports

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Technical complications associated with the use of epidural catheters account for a significant proportion of failures of this technique. Misplacement and knotting of epidural catheters are complications rarely described in both human and veterinary literature. The method used to identify and confirm the correct position of the catheter in the epidural space plays an important role in preventing such complications. However, some of the techniques commonly used can still lead to an equivocal catheter placement. We report a case where loss of resistance, positive analgesic effect and motor deficits of both hindlimbs masked a misplaced epidural catheter in a dog, with knotting of the catheter occurring when removal was attempted.

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Fluoroscopically Guided Cervical Interlaminar Epidural Injections Using the Midline Approach: An Analysis of Epidurography Contrast Patterns

Abstract: Two milliliters of contrast solution can provide optimal dispersion of contrast in a ventral and longitudinal spread.

Cited by 32 publications

References 8 publications

Optimal volume of injectate for fluoroscopy-guided cervical interlaminar epidural injection in patients with neck and upper extremity pain

Optimal volume of injectate for fluoroscopy-guided cervical interlaminar epidural injection in patients with neck and upper extremity pain

Cervical Foraminal Versus Interlaminar Epidurals: Risks, Benefits, and Alternatives

Epidural catheter misplacement and knot formation within the hypoaxial musculature of a dog

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