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http://dx.doi.org/10.5762/KAIS.2017.18.8.317

Effect of Lumbar Epidural Nerve Block using the Transforamimnal Approach and the Interlaminar Approach on Magnetic Resonance Imaging Findings  

Hwang, Byeong-Mun (Department of Anesthesiology and Pain Medicine, School of Medicine, Kangwon National University)
Publication Information
Journal of the Korea Academia-Industrial cooperation Society / v.18, no.8, 2017 , pp. 317-323 More about this Journal
Abstract
This study was conducted to investigate the differences in magnetic resonance imaging (MRI) findings after lumbar epidural nerve block using the transforaminal approach and the interlaminar approach in patients with low back pain. This study was an observational analysis study of abnormal findings of MRI after epidural nerve block. This study included 78 patients who underwent MRI at approximately 24 h after lumbar epidural nerve block at a pain clinic of a university hospital between January 2007 and December 2016. Among patients who received epidural nerve block, 36 used the interlaminar approach and 42 used the transforaminal approach. The incidence of patients with abnormal changes in MRI findings was higher among patients using the interlaminar approach (53%) than those using the transforaminal approach (7%). Abnormal MRI findings included epidural air or fluid, needle tracks, and soft tissue changes, with epidural air being the most frequent abnormal finding (72%). We recommend use of the transforaminal approach to reduce the possibility of misreading or difficulty in interpretation of images of patients who underwent MRI at approximately 24 h after lumbar epidural nerve block. Practitioners should consider the possibility of abnormal findings such as epidural air on MRI in cases of epidural nerve block using the interlaminar approach.
Keywords
Air; Epidural; Interlaminar; Magnetic resonance imaging; Nerve; Transforaminal;
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