Accuracy of Live Fluoroscopy to Detect Intravascular Injection During Lumbar Transforaminal Epidural Injections

• DOI: 10.3344/kjp.2010.23.1.18
• Publication Date: 2010-03-12T10:58:34Z
• Authors: Min Hye Lee; Kyung Seung Yang; Young Hoon Kim; Hyun Do Jung; Su Jin Lim; Dong Eon Moon
• Keywords: Subtraction; Digital subtraction angiography; Epidural steroid injection

Background:Complications following lumbar transforaminal epidural injection are frequently related to inadvertent vascular of corticosteroids.Several methods have been proposed reduce the risk injection.The generally accepted technique during steroid is intermittent fluoroscopy.In fact, this may miss uptake due rapid washout.Because fleeting appearance contrast patterns, live fluoroscopy recommended injection.However, when patterns overlapped by expected it hard distinguish them even on fluoroscopy. Methods:During 87 injections, dynamic flows were observed under with using digital subtraction enhancement.Two fluoroscopic images saved from each injection.These injections performed five physicians experience independently.Accuracy was determined comparing interpretation images. Results:Using guidance confirmation, twenty cases intravascular found (the rate incidence 23%).There no significant difference in based either gender or diagnosis.Only predicted flash aspiration blood (sensitivity = 25%).Under confirmation predict injection, twelve 60%). Conclusions:This finding demonstrate that imaging superior detecting injection.(