Lumbar transforaminal epidural steroid injection (fluoroscopic-guided)
Diagnosis not applicable
Presentation
Ongoing left L5 radicular symptoms. Prior MRI showed an L4/5 disc bulge compressing the descending L5 nerve.
Patient Data
Age: 50 years
Gender: Male
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/104409/annotated_viewer_json?lang=us"}
Using a supraneural oblique approach and a 22 gauge Quincke needle, the targeted superoposterior quadrant of the subpedicular space was achieved. Injection of iodinated contrast confirmed an extravascular position with epidural spill.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/104410/annotated_viewer_json?lang=us"}
Injection of steroid containing injectate disperses the previously injected contrast.
Case Discussion
Technically successful transforaminal nerve root injection (TFESI). Different approaches can be used, with a supraneural technique shown. The tip of the needle is slightly bent to help navigate when the needle is at depth.
Unable to process the form. Check for errors and try again.