Multislice CT fluoroscopy-assisted cervical transforaminal injection of steroids: technical note.
METHODS
A prospective study of 19 consecutive patients who underwent multislice computed tomography (CT)-guided cervical transforaminal steroid injection.


OBJECTIVE
To evaluate the feasibility and the outcome of cervical transforaminal steroid injection guided by multislice CT fluoroscopy.


BACKGROUND
Cervical transforaminal steroid injection has been accepted as an effective therapeutic modality for radiculopathy that results from a cervical herniated disc or stenosis. However, there has been debate on the safety of the transforaminal approach technique, with C-arm fluoroscopy guidance, compared with the posterior interlaminar approach. We present an advanced approach technique for cervical transforaminal steroid injection guided by multislice CT fluoroscopy and the clinical outcomes.


METHODS
Nineteen consecutive patients presenting with radiating pain to the shoulder or arm had CT or magnetic resonance image scan findings compatible with cervical herniated disc or foraminal stenosis and were recruited to participate in this study. They underwent cervical transforaminal steroid injection using multislice CT fluoroscopy guidance up to 3 times with a minimal interval of 2 weeks. The participants were evaluated for the safety and efficacy of this technique for a follow-up period of 16 weeks.


RESULTS
No serious complications were found during and after the procedures. Eleven patients received a second steroid injection but none required a third injection over the 16-week follow-up period. The mean visual analog scale score improved significantly at 2, 4, 8, and 16 weeks (P < 0.001).


CONCLUSIONS
The multislice CT fluoroscopy-guided approach is feasible and a safe and effective approach for cervical transforaminal steroid injection. With the advantages of safety for the patient and precise placement of the needle for injection, this technique might be an additional option and may eventually replace the conventional C-arm fluoroscopy-guided cervical transforaminal steroid injection technique.
Kim
Hoondo
H
Department of Anesthesiology and Pain Medicine, Gimpo Airport Wooridul Spine Hospital, Seoul, Korea. hoondo_kim@hanmail.net
Lee
Sang-Ho
SH
Kim
Myung-Ho
MH
D000700:Analgesics / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007278:Injections, Spinal / Q000379:methods; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain; D011843:Radiculopathy / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D015641:Radiography, Interventional / Q000379:methods; D013130:Spinal Stenosis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D013256:Steroids / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D000700:Analgesics; D000893:Anti-Inflammatory Agents; D013256:Steroids