On the geometry of fluoroscopy views for cervical interlaminar epidural injections.

OBJECTIVES To describe how the anatomy of the cervicothoracic vertebrae predicates the appropriate fluoroscopic views for confirming safe needle placement during the performance of interlaminar cervical epidural injections. METHODS AND RESULTS Illustrations, cadaver models, and radiographic images were correlated and used to illustrate and derive a mathematical model to demonstrate the utility of a contralateral oblique fluoroscopic view during the performance of cervical interlaminar injections. CONCLUSIONS When confirming needle placement during a cervical interlaminar epidural injection, in addition to the anterior-posterior fluoroscopic view, the oblique image, contralateral to the needle tip position, may provide superior information to that afforded by a lateral view.