Comparative analysis of contrast distribution in cervical epidural steroid injections utilizing a modified paramedian interlaminar approach with varied needle tip positions: A randomized controlled trial

被引:1
作者
Yoo, Seung Hee [1 ]
Lee, Min Jin [1 ]
Jue, Mi Jin [1 ]
Won, Yoonsun [1 ]
Kim, Won-joong [1 ]
机构
[1] Ewha Womans Univ, Mokdong Hosp, Dept Anesthesiol & Pain Med, Coll Med, 1071 Anyangcheon Ro, Seoul, South Korea
关键词
analgesia; epidural; cervical vertebrae; contrast media; injections; intervertebral disc displacement; neck pain; radiculopathy; cervical; spinal stenosis; CONTRALATERAL OBLIQUE VIEW; MIDLINE APPROACH; RADICULOPATHY; FLUOROSCOPY; MANAGEMENT; SUPERIOR; EFFICACY; SPACE; PAIN; FLOW;
D O I
10.1111/papr.13401
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
BackgroundRecent advancements in cervical interlaminar epidural steroid injections have given rise to the modified paramedian interlaminar (mPIL) approach. The objective of this study was to perform an analysis of the contrast spread pattern within the cervical epidural space, taking into account different needle tip positions in the mPIL approach.MethodsA total of 48 patients were included in the study and randomly assigned to either the medial or lateral group based on the needle tip's position in the anterior-posterior view. The primary outcome measured was the contrast flow under fluoroscopic visualization. As a secondary outcome, we analyzed the location of the needle tip position in both lateral and contralateral oblique views. Clinical effectiveness was assessed by measuring pain intensity and functional disability post-procedure.ResultsSignificant disparities were noted in the ventral distribution of contrast between the medial and lateral groups. In the lateral images, needle tips in the lateral group were positioned more ventrally compared to those in the medial group. Both groups exhibited statistically significant improvements in neck and radicular pain, as well as functional status, 4 weeks after treatment, with no significant differences between them.ConclusionsOur results suggest that the ventral dispersion of contrast material during cervical interlaminar epidural steroid injections using the mPIL approach may vary depending on the needle tip location.
引用
收藏
页码:1059 / 1067
页数:9
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