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Lumbar Transforaminal and Nerve Root Injections: Fluoroscopy 

Lumbar Transforaminal and Nerve Root Injections: Fluoroscopy
Lumbar Transforaminal and Nerve Root Injections: Fluoroscopy
Multimodality Imaging Guidance in Interventional Pain Management

Vahid Grami

, Salim M. Hayek

, and Samer N. Narouze


The transforaminal approach, compared with the interlaminar approach, allows injectate delivery directly at the target nerve root, placing greater amounts of medication at the location of the suspected pathology. The utility of selective nerve root injections includes blocking with local anesthetics specific nerve roots suspected of transmitting radicular symptoms. These diagnostic radicular blocks are often used for presurgical planning. The fluoroscopic-guided lumbar transforaminal epidural steroid injection approaches mentioned in this chapter have been described to safely and effectively deposit medication in the epidural space, adjacent to affected nerve roots transmitting pain signals. It is imperative that proper patient selection, physician training, thorough knowledge of anatomy, vigilance, and effective use of fluoroscopy and radiocontrast dye help to avoid catastrophic tissue damage and embolization.

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