Cervical transforaminal epidural steroid injection (CT-guided)

Case contributed by Dr Dai Roberts

Presentation

Right-sided neck and arm pain

Patient Data

Age: 45 years
Gender: Male

CT-guided transforaminal epidural steroid injection (TFESI) 

- Smaller 30G needle used to aid correct needle position and administer local anesthesia.  

- Final pre-contrast position of the 25G Quincke needle.

- Post-contrast images show contrast extends through the targeted right C5/6 foramen with epidural extension.

Case Discussion

Planning CT-guided procedures and ensuring an accurate needle entry point makes for a more straightforward procedure.  This can be achieved in multiple ways and there are numerous radio-opaque grids available.  The curved shape of the neck and lateral needle entry point can make the application of some grids more difficult.  A small needle, such as a short 30G needle, can help to check the needle entry position after marking, before the Quincke needle is used, is one such technique.  

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Case information

rID: 75214
Published: 21st Mar 2020
Last edited: 10th May 2020
Inclusion in quiz mode: Included
Institution: St. Paul's Hospital

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