• Pain physician · Mar 2023

    Needle Depth and Angle for Lumbar Interlaminar Epidural Injection Using Magnetic Resonance Imaging and C-Arm Measurements.

    • Jiyeon Kim, Minjung Kim, Jung Eun Kim, Yubi Kwon, and Jae Hun Kim.
    • Sungmo Top Orthopedic Clinic, Mapo, Seoul, Korea.
    • Pain Physician. 2023 Mar 1; 26 (2): E83E90E83-E90.

    BackgroundInterlaminar epidural injection (ILEI) is used to relieve low back pain, with or without radiating pain. The distance from the skin to the epidural space determines the needle depth and may be influenced by the patient's body measurements.ObjectivesThe objective of this study was to investigate the correlation between needle depth for ILEI and patients' body profiles, including weight, height, and body mass index (BMI), using magnetic resonance imaging (MRI) and also to compare the needle depth and angle between MRI and C-arm fluoroscopic images of ILEI.Study DesignThis was a retrospective study.SettingThis study was conducted at a single Department of Anesthesiology and Pain Medicine of Konkuk University Medical Center.MethodsThis retrospective study reviewed patients who underwent MRI and ILEI. The needle depth and caudal angle were measured on the sagittal view of MRI and C-arm images for L3-L4, L4-L5, and L5-S1 ILEI.ResultsOverall, 386 patients were reviewed. For MRI, the mean value of the needle angle given caudally was 14.70, 12.06, and 11.33 for L3-4, L4-5, and L5-S1 ILEIs, respectively. Mean values of needle depth were 52.17, 52.09, and 47.91 mm for L3-4, L4-5, and L5-S1 ESIs, respectively. Height combined with weight and BMI had a higher correlation with needle depth than weight and height. In the comparison between MRI and fluoroscopy, needle depth at L5-S1 and caudal angle at L3-4 and L4-5 were significantly correlated.LimitationsThis study was a retrospective study conducted at a single center.ConclusionHeight combined with weight and BMI can help estimate the optimal needle depth from the skin to the epidural space. Needle depth in L5-S1 and caudal angle in L3-4 and L4-5 of MRI were correlated with those of fluoroscopy of ILEI.

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