CT fluoroscopy-assisted cervical transforaminal steroid injection: tips, traps, and use of contrast material.
OBJECTIVE
CT fluoroscopy-assisted cervical transforaminal steroid injection is an effective therapeutic option for cervical radiculopathy, yet it is approached with trepidation by some interventionalists. CT fluoroscopy is superior to conventional fluoroscopy for delineating complex anatomic relations in the neck but must be combined with careful technique to avoid rare but serious complications. We describe the anatomy of the neural foramen, our technique of CT fluoroscopy-assisted cervical transforaminal steroid injection, and the CT appearance of appropriate and inappropriate needle positions.


CONCLUSIONS
Understanding anatomy will help to avoid complications and optimize the therapeutic potential of cervical transforaminal steroid injection. Use of contrast material for CT fluoroscopic guidance facilitates appropriate needle positioning and reduces the risk of complications.
Hoang
Jenny K
JK
Department of Radiology, Division of Neuroradiology, Duke University Medical Center, Durham, NC 27710, USA.
Apostol
Marc A
MA
Kranz
Peter G
PG
Kilani
Ramsey K
RK
Taylor
Jeffrey N
JN
Gray
Linda
L
Lascola
Christopher D
CD
D000328:Adult; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D008297:Male; D008875:Middle Aged; D011843:Radiculopathy / Q000188:drug therapy*; D013256:Steroids / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D003287:Contrast Media; D013256:Steroids