Unintentional lumbar facet joint injection guided by fluoroscopy during interlaminar epidural steroid injection: a retrospective analysis

被引:10
作者
Kim, Min Jae [1 ]
Choi, Yun Suk [1 ]
Suh, Hae Jin [2 ]
Kim, You Jin [1 ]
Noh, Byeong Jin [3 ]
机构
[1] Jeju Natl Univ, Sch Med, Dept Anesthesiol & Pain Med, 15 Aran 13 Gil, Jeju 63241, South Korea
[2] Hankook Hosp, Dept Anesthesiol & Pain Med, Jeju, South Korea
[3] Jeju Natl Univ, Sch Med, Jeju, South Korea
关键词
Contrast pattern; Epidural space; Epidural steroid injection; Facet joint injection; Fluoroscopy; Spinal central stenosis; ARTHROGRAPHY; SPONDYLOLYSIS;
D O I
10.3344/kjp.2018.31.2.87
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: An epidural steroid injection (ESI) is a commonly administered procedure in pain clinics. An unintentional lumbar facet joint injection during interlaminar ESI was reported in a previous study, but there has not been much research on the characteristics of an unintentional lumbar facet joint injection. This study illustrated the imaging features of an unintentional lumbar facet joint injection during an interlaminar ESI and analyzed characteristics of patients who underwent this injection. Methods: From December 2015 to May 2017, we performed 662 lumbar ESIs and we identified 24 cases (21 patients) that underwent a lumbar facet joint injection. We gathered data contrast pattern, needle approach levels and directions, injected facet joint levels and directions, presence of lumbar spine disease as seen on magnetic resonance images (MRI), and histories of lumbar spine surgeries. Results: The contrast pattern in the facet joint has a sigmoid or ovoid contrast pattern confined to the vicinity of the facet joint. The incidence of unintentional lumbar facet joint injection was 3.6%. The mean age was 68.47 years. Among these 21 patients, 14 (66.7%) were injected in the facet joint ipsilaterally to the needle approach. Among the 20 patients who received MRI, all (100%) had central stenosis and 15 patients (75%) had severe stenosis. Conclusions: When the operator performs an interlaminar ESI on patients with central spinal stenosis, the contrast pattern on the fluoroscopy during interlaminar ESI should be carefully examined to distinguish between the epidural space and facet joint.
引用
收藏
页码:87 / 92
页数:6
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