Interlaminar epidural steroid injection (fluoroscopic guided)

Case contributed by Dr Dai Roberts

Presentation

Bilateral leg pain, previous ILESI worked well.

Patient Data

Age: 80
Gender: Female

A 22G Tuohy targets the L5-S1 interlaminar space.  Pre and post injection of iodinated contrast lateral images are taken, confirming the needle tip is in the dorsal epidural space, extending both cranial and caudally.  The final post injection posterior image further displays contrast in the epidural space, where it has a non uniform and patchy appearance.  

Case Discussion

Technically successful L5-S1 ILESI.  An epidural injection of contrast should not be uniform and should be patchy, whereas an intrathecal injection will be uniform and extend to touch the anterior portion of the thecal sac.  

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Case information

rID: 75868
Published: 26th Apr 2020
Last edited: 27th Apr 2020
Inclusion in quiz mode: Included
Institution: St. Paul's Hospital