The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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An Alternative Approach to Needle Placement in Cervicothoracic Epidural Injections

  • Park, Seung-Yong (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Leem, Jung-Gil (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung, Sung-Hwan (Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, University of Ulsan Collage of Medicine) ;
  • Kim, Young-Ki (Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, University of Ulsan Collage of Medicine) ;
  • Koh, Won-Uk (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2012.05.07
  • Accepted : 2012.06.08
  • Published : 2012.07.01
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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.

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References

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  1. A New Way to Obtain Clear Lateral Fluoroscopic Pictures for Cervical Epidural Steroid Injections vol.28, pp.1, 2013, https://doi.org/10.1097/BTO.0b013e31828c6df7
  2. Optimal volume of injectate for fluoroscopy-guided cervical interlaminar epidural injection in patients with neck and upper extremity pain vol.95, pp.43, 2016, https://doi.org/10.1097/MD.0000000000005206