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Thoracic Epidural and Nerve Root Injections: Fluoroscopy 

Thoracic Epidural and Nerve Root Injections: Fluoroscopy
Chapter:
Thoracic Epidural and Nerve Root Injections: Fluoroscopy
Author(s):

Jianguo Cheng

DOI:
10.1093/med/9780199908004.003.0013
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date: 19 August 2019

Thoracic nerve root blocks can be achieved by interlaminal epidural, transforaminal epidural, paravertebral, and selective nerve root injections. The interlaminal approach allows blocking multiple nerve roots bilaterally, while the transforaminal approach has the advantage of depositing the injectate primarily to the anterior epidural space on the side of the injection, closer to the pathology. The paravertebral approach is often used to block multiple nerve roots on the side of injection, and the selective nerve root block is used to target a specific nerve root using a small volume of injectate. Fluoroscopy-guided injection the most commonly used technique. Contrast materials are often used to confirm the appropriate needle placement and monitor the spread of the injectate. Thoracic nerve root block and transforaminal epidural block are perceived as technically demanding due to anatomic complexity of the thoracic spine, its proximity to the lungs and major vasculature, and potential complications.

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