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Cervical Interlaminar Epidural Injections: Fluoroscopy 

Cervical Interlaminar Epidural Injections: Fluoroscopy
Cervical Interlaminar Epidural Injections: Fluoroscopy
Multimodality Imaging Guidance in Interventional Pain Management

Dmitri Souzdalnitski

and Samer N. Narouze


Interlaminar cervical epidural steroid injections (CEI) have been considered an effective treatment for neck pain accompanied by radicular pain or radiculopathy secondary to the herniated cervical disc. Also, CEI may be useful in the treatment of intracranial hypotension secondary to a spontaneous cerebrospinal fluid (CSF) leak. Computer tomography (CT) uses significantly higher doses of radiation for patients. Fluoroscopy uses less radiation than CT, and helps to correctly identify the site of injection and guide the procedure with, likely, less trauma to ligaments, periosteum, epidural vessels, cervical spinal cord, nerve roots, and other important structures. It may help to avoid technical difficulties and complications associated with CEI in patients with postsurgical conditions, congenital deformities, and others. Digital subtraction angiography (DSA) fluoroscopy can help to identify intravascular injection during CEI; it advisable to use it for all CEI if there are no contraindications.

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