Dispersal Pattern of Injectate after Lumbar Interlaminar Epidural Spinal Injection Evaluated with Computerized Tomography
نویسندگان
چکیده
Study Design Retrospective analysis of lumbar computed tomographic epidurograms. Objective To evaluate the dispersal pattern of injectate after interlaminar lumbar epidural steroid injections. Summary Prior studies have evaluated the dispersal patterns of injectate after lumbar epidural steroid injections using fluoroscopy with varying results. To date, there have been no studies evaluating the dispersal pattern utilizing computerized tomography. Methods Ten epidurograms were analyzed after lumbar interlaminar epidural steroid injection. The epidurograms were examined, evaluating the dispersal pattern in longitudinal flow as well as circumferential flow. In addition, pain values were assessed with the visual analogue scale. Results Mean diffusion in the rostral direction was 9.8 cm (standard deviation 4.0 cm, range 4.0 to 15.0 cm). Mean diffusion in the caudal direction was 5.4 cm (standard deviation 1.4 cm, range 3.0 to 8.0 cm). Both rostral and caudal flow had a p value < 0.001. The circumferential flow was 360 degrees in 9 of 10 cases. In addition, there was significant (p = 0.006) reduction in pain. Conclusion Interlaminar lumbar epidural steroid injections are an effective treatment modality for various spine-related conditions. The injectate diffuses throughout the epidural space with nearly uniform circumferential flow as well as significant rostral and caudal flow.
منابع مشابه
Foraminal Hematoma Following Lumbar Transforaminal Steroid Injection Causing Reversible Motor Deficit: A Case Report
Lumbar radiculopathy is a common disorder with a prevalence of 2.2-8% [1]. Mechanical compression by a herniated lumbar disc or foraminal stenosis, along with an induced inflammatory response, is thought to underlie radicular pain [2]. Transforaminal epidural steroid injections (TFESI) are widely used for the management of lumbar radicular pain provoked by herniated discopathy and spinal stenos...
متن کاملInjectate Volumes Needed to Reach Specific Landmarks and Contrast Pattern in Kambin's Triangle Approach with Spinal Stenosis
OBJECTIVE To identify the volumes of contrast material needed to reach the specific landmarks and contrast pattern during Kambin's triangle approach (KB-A) in lumbar spinal stenosis. METHOD Sixty patients undergoing KB-A were investigated. Fifty-six patients were included in this study. KB-A were performed with the use of contrast-enhanced fluoroscopic visualization. After confirming the appr...
متن کاملParaplegia following a thoracolumbar transforaminal epidural steroid injection.
BACKGROUND In recent years, transforaminal epidural injections have emerged as an alternative to interlaminar and caudal epidural steroid injections. The rationale for utilizing transforaminal epidural injections has been described for diagnostic as well as therapeutic purposes. The evidence for lumbar transforaminal epidural steroid injections in managing lumbar nerve root pain is strong, wher...
متن کاملSpontaneous Absorption of a Lumbar Epidural Hematoma after Interlaminar Epidural Steroid Injection in a Patient with Spinal Stenosis: Close Observation as a Treatment Strategy
متن کامل
SpontaneouS ReSolution of pReSumed acute epiduRal Hematoma foRmation afteR lumbaR epiduRal SteRoid injection
A 76-year-old woman with mild lumbar spinal stenosis (L4-L5, L5-S1) and lumbar dextroscoliosis, previously on 81mg of aspirin daily (discontinued at 14 days prior to procedure) and not on anticoagulation therapy, underwent a lumbar epidural steroid injection (T12-L1). Post-procedurally, she developed bilateral leg paralysis. A magnetic resonance imaging (MRI) study revealed a fluid collection c...
متن کامل