CT-guided spinal epidural interlaminar injection

Case contributed by Frank Gaillard
Diagnosis not applicable

Patient Data

Gender: Male

Spinal epidural injection CT interlaminar.

Case Discussion

The technique in this procedure was: 

  1. obtain a localizing scan with some way of demarcating the skin (in this case, a radiopaque 'grid')
  2. choose a location that gives as vertical as possible route to the epidural space
  3. local anesthetic along proximal track (optional)
  4. advance needle until slight resistance (often gritty) is felt (ligamentum flavum)
  5. check location
  6. attach empty syringe with 3-4 ml of room air and keep plunger pulled while advancing remaining distance
  7. epidural space has low / negative pressure and air is easily injected
  8. confirm the extrathecal location
  9. inject steroid and local anesthetic

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