Contralateral oblique view is superior to lateral view for interlaminar cervical and cervicothoracic epidural access.

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 utilit...

Contralateral Oblique View Is Superior to the Lateral View for Lumbar Epidural Access.

OBJECTIVE The purpose of this study was to perform a comparative analysis of the contralateral oblique (CLO) view and the lateral view for lumbar interlaminar epidural access. DESIGN After the epidural space was accessed, fluoroscopic images at eight different angles (antero-posterior view, multiple CLO, and lateral view) were prospectively obtained. Visualization and location of needle tip r...

Optimal Angle of Contralateral Oblique View in Cervical Interlaminar Epidural Injection Depending on the Needle Tip Position.

BACKGROUND Chronic neck and upper extremity pain associated with cervical origin is common, and cervical interlaminar epidural steroid injections (CILESIs) are frequently used to manage the symptoms of cervical spinal disorders. However, CILESIs are associated with risks such as dural puncture and cord injury. OBJECTIVES We aimed to determine the optimal needle tip visualization, in order to ...

Response to Letter: Optimal Angle of Contralateral Oblique View in Cervical Interlaminar Epidural Injection: Safety or Precision?

Reliability and Safety of Contra-Lateral Oblique View for Interlaminar Epidural Needle Placement: Standardization of the Appropriate Angle.

In this large retrospective review of a clinical case, Derby et al (1) again show that the contralateral oblique (CLO) view is safe and accurate. Loss of resistance cannot be expected before the ventral interlaminar line (VILL) and the needle may be passed with impunity to just before this line. As the interlaminar line is accessed, the loss of resistance should occur immediately or shortly the...