Pain physician
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Comparative Study
Detection of Intravascular Injection During Cervical Transforaminal Epidural Injection: A Comparison of Digital Subtraction Angiography and Real Time Fluoroscopy.
Transforaminal epidural injection (TFEI) with local anesthetics and steroids are effective in treating spinal radicular pain. However, inadvertent intravascular injection can lead to severe neurologic complications. To reduce complications of intravascular injection, use of imaging modality, such as real-time fluoroscopy (RTF) or digital subtraction angiography (DSA), has been recommended. DSA is an imaging technique that can clearly visualize the blood vessels from surrounding bones or dense soft tissues by subtracting the pre-contrast image from the image after injecting contrast medium. ⋯ Analgesia, bleeding, clinical trials, complications, diagnostic equipment, epidural, radiculopathy, spine.
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The extraforaminal ligaments between the L1-L5 lumbar spinal nerves and the tissues surrounding the intervertebral foramina (IVF) have been well studied. However, little research has been performed to describe the local anatomy of the entrance zones at the L1-L5 level. Detailed anatomic studies of the intraforaminal ligaments (IFLs) in the entrance zones at the L1-L5 levels have not been performed. ⋯ Clinical Anatomy, microdissection, intraforaminal ligament, the entrance zone, L1-L5 intervertebral foramen, endoscopic spinal adhesiolysis, sacral hiatus, cerebrospinal fluid leakage, dural laceration.