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ANALGESIA

Fluoroscopically Guided Cervical Interlaminar Epidural Injections Using the Midline Approach: An Analysis of Epidurography Contrast Patterns

Kwang Su Kim, MD^*, Sung Sik Shin, MD^*, Tae Sam Kim, MD^*, Chang Young Jeong, MD, Myung Ha Yoon, MD, and Jeong Il Choi, MD

From the *Department of Anesthesiology and Pain Medicine, Gwangju Saewoori Spine Hospital, Gwangju, Korea; and Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea.

Address correspondence and reprint requests to Kwang Su Kim, MD, Department of Anesthesiology and Pain Medicine, Gwangju Saewoori Spine Hospital, 180-28 Hwajungdong, Seogu, Gwangju 502-240, Korea. Address e-mail to rockingstone{at}hanmail.net.

Abstract

BACKGROUND: The purpose of this study was to evaluate epidurography contrast patterns in fluoroscopically guided cervical interlaminar epidural injections using the midline approach.

METHODS: All epidural injections were performed at the C6-7 level in the prone position. Epidurography was performed using a fixed amount of iotrolan 240 mg I/mL (1, 2, 3 mL).

RESULTS: The rate of ventral epidural spread was 56.7% in Group A (1 mL), 90% in Group B (2 mL), and 93.3% in Group C (3 mL).

CONCLUSIONS: Two milliliters of contrast solution can provide optimal dispersion of contrast in a ventral and longitudinal spread.