Transforaminal Epidural Injection

unilateral and/or radicular symptoms 있는 환자

 

prone position

 

C-arm oriented posterolaterally ;

라테랄 각도는 30~45도로 Interlaminar inj. 때보다 좀 더 크게

caudal angulation 은 target foramen 위쪽 페디클의 하부 표면이 잘 보이게 위치시킨다.

 

니들을 medial to the center of the pedicle 로 진행

 

(A) Needle placement for a transforaminal injection. The needle tip is adjacent to the pedicle from a posterolateral approach. A more medial needle placement facilitates epidural reflux. Oblique (B) and AP (C) radiographs following needle placement subjacent to the pedicle.

CSF를 흡인해보고 4~5ml 조영제 주입

proximal nerve sheath, with reflux of contrast into the adjacent epidural space 확인

(A) AP radiograph during injection of contrast media for a transforaminal injection at L5-S1. (B) After injection of 5 mL of contrast medium, contrast is seen along the L5 nerve root and within the epidural space from L2-3 to the L5- S1 level.

2 to 3 mL of water-soluble steroid mixture, mixed with 3 to 5 mL of local anesthetic, is injected.

 

Postinjection films are obtained to document dispersal of the injected materials.