An Alternative Approach to Needle Placement in Cervicothoracic Epidural Injections
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
The use of fluoroscopy guidance together with the loss of resistance technique during epidural injections has been advocated lately; moreover, epidural injections in the absence of fluoroscopic guidance have a high rate of inaccurate needle-tip placement during the injections. However, the approach to the lower cervical and upper thoracic epidural space may be challenging due to its obscure lateral fluoroscopic views from overlying normal tissue structures. In this case, we report an alternative oblique C-arm fluoroscopy guided view approach to supplement the standard anterior-posterior and lateral fluoroscopic views to facilitate successful needle placement and precise anatomical localization of the epidural space.
Abstract
The use of fluoroscopy guidance together with the loss of resistance technique during epidural injections has been advocated lately; moreover, epidural injections in the absence of fluoroscopic guidance have a high rate of inaccurate needle-tip placement during the injections. However, the approach to the lower cervical and upper thoracic epidural space may be challenging due to its obscure lateral fluoroscopic views from overlying normal tissue structures. In this case, we report an alternative oblique C-arm fluoroscopy guided view approach to supplement the standard anterior-posterior and lateral fluoroscopic views to facilitate successful needle placement and precise anatomical localization of the epidural space.
참고문헌 (12)
- Bartynski WS, "Incorrect needle position during lumbar epidural steroid administration: inaccuracy of loss of air pressure resistance and requirement of fluoroscopy and epidurography during needle insertion", AJNR Am J Neuroradiol, 26, pp.502~505 (2005)
- Goel A, "Contrast flow characteristics in the cervical epidural space: an analysis of cervical epidurograms", Spine, 31, pp.1576~1579 (2006)
- Lirk P, "Cervical and high thoracic ligamentum flavum frequently fails to fuse in the midline", Anesthesiology, 99, pp.1387~1390 (2003)
- Tae Sam Kim, "Air Bubbles Mimic Disc Herniation in MRI after Cervical Epidural Block", The Korean Journal of Pain, 23(3), pp.202~206 (2010), 대한통증학회
- Singh H, "Novel fluoroscopic technique for localization at cervicothoracic levels", J Spinal Disord Tech, 22, pp.615~618 (2009)
- Zhu J, "Alternative approach to needle placement in cervical spinal cord stimulator insertion", Pain Physician, 14, pp.195~210 (2011)
- Sae Young Kim, "Epidural Blood Patches in a Patient With Multi-level Cerebrospinal Fluid Leakage That Was Induced by Spontaneous Intracranial Hypotension", The Korean Journal of Pain, 23(1), pp.46~50 (2010), 대한통증학회
- Cho KI, "Spontaneous intracranial hypotension: efficacy of radiologic targeting vs blind blood patch", Neurology, 76, pp.1139~1144 (2011)
- Huston CW, "Cervical epidural steroid injections in the management of cervical radiculitis: interlaminar versus transforaminal", A review. Curr Rev Musculoskelet Med, 2, pp.30~42 (2009)
- Han KR, "Distance to the adult cervical epidural space", Reg Anesth Pain Med, 28, pp.95~97 (2003)
- Collier CB, "Accidental subdural injection during attempted lumbar epidural block may present as a failed or inadequate block: radiographic evidence", Reg Anesth Pain Med, 29, pp.45~51 (2004)
- Abbasi A, "The "swimmer's view" as alternative when lateral view is inadequate during interlaminar cervical epidural steroid injections", Pain Med, 11, pp.709~712 (2010)