• Reg Anesth Pain Med · Mar 2022

    Randomized Controlled Trial

    Comparison of contralateral oblique view with the lateral view for fluoroscopic-guided cervical epidural steroid injection: a randomized clinical trial.

    • Ji-Hoon Sim, Hyun-Jung Kwon, Chan-Sik Kim, Eun Ha Kim, Doo-Hwan Kim, Seong-Soo Choi, and Jin-Woo Shin.
    • Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
    • Reg Anesth Pain Med. 2022 Mar 1; 47 (3): 171-176.

    BackgroundCervical epidural steroid injection is associated with rare but potentially catastrophic complications. The contralateral oblique (CLO) view may be a safe and feasible alternative to the lateral (LAT) view for fluoroscopic-guided cervical epidural steroid injection. However, evidence for the clinical usefulness of the CLO view for cervical epidural steroid injection is lacking. We assessed the clinical usefulness of the CLO view for cervical epidural steroid injection in managing cervical herniated intervertebral discs.MethodsPatients were randomly assigned to receive fluoroscopic-guided cervical epidural steroid injection under LAT view or CLO view at 50±5° degrees groups. The primary outcome was the needling time comparison between the two groups. Secondary outcomes were comparison of first-attempt success rate, needle tip visualization and location, total number of needle passes, final success rate, crossover success rate and false-positive/negative loss of resistance. Complications and radiation dose were also compared.ResultsThe needling time significantly decreased in the CLO than in the LAT group. The first-attempt success rate was significantly higher in the CLO compared with the LAT group. The needle tip was clearly visualized (p<0.001) and located more often on (or just anterior to) the ventral interlaminar line (p<0.001) in the CLO than in the LAT group. There were significantly fewer needle passes (p=0.019) in the CLO than in the LAT group. There were no significant differences in the final success, crossover success, false-positive/negative loss of resistance or radiation dose between the groups. Two (5.9%) cases in the LAT group experienced complications.ConclusionThe CLO view may be recommended for fluoroscopic-guided cervical epidural steroid injection, considering its better clinical usefulness over the LAT view.© American Society of Regional Anesthesia & Pain Medicine 2022. No commercial re-use. See rights and permissions. Published by BMJ.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…