Document Detail

Alternative approach for lumbar transforaminal epidural steroid injections.
MedLine Citation:
PMID:  21785476     Owner:  NLM     Status:  MEDLINE    
The traditional superoanterior approach for transforaminal epidural steroid injection (TFESI) carries a risk of complication by obstructing arterial flow to the anterior portion of the spinal cord by puncturing the spinal radicular artery that passes through the superoanterior foraminal zone or "safe triangle" zone, which does not describe vascular safety, but rather describes neural safety. Consequently, multiple disasters have been described in recent years with transforaminal epidural injections. They are utilized extensively even though their effectiveness has been debated. Here we describe a dorsal technique through transforaminal epidural injections to place the tip of the needle immediately dorsal to the dorsal root ganglion. Multiple different techniques have been discussed and described in recent years, the majority of them to avoid the radicular artery injection. The primary goal of this paper is to describe another posterior approach to place the tip of spinal needle directly toward the posterior epidural space to avoid puncturing the spinal radicular artery and minimize nerve root penetrations while delivering medication into the epidural space through the foramen.
Jie Zhu; Frank J E Falco; Ferdinand Formoso; Obi Onyewu; Franklin L Irwin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pain physician     Volume:  14     ISSN:  2150-1149     ISO Abbreviation:  Pain Physician     Publication Date:    2011 Jul-Aug
Date Detail:
Created Date:  2011-07-25     Completed Date:  2011-11-22     Revised Date:  2012-07-12    
Medline Journal Info:
Nlm Unique ID:  100954394     Medline TA:  Pain Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  331-41     Citation Subset:  IM    
Mid Atlantic Spine & Pain Physicians, Newark, DE, USA.
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MeSH Terms
Adrenal Cortex Hormones / administration & dosage*
Injections, Epidural / methods*
Lumbar Vertebrae
Reg. No./Substance:
0/Adrenal Cortex Hormones
Comment In:
Pain Physician. 2012 May-Jun;15(3):E346-347   [PMID:  22622918 ]
Pain Physician. 2011 Sep-Oct;14(5):E459-60; author reply E460-1   [PMID:  21927057 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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