Korean J Pain.  2006 Jun;19(1):51-55. 10.3344/kjp.2006.19.1.51.

CT Guided Cervical Transforaminal Steroid Injection: 2 Months Follow-up

• Kim H
• Lee SH
• Kim MH

• KMID: 2278015
• DOI: http://doi.org/10.3344/kjp.2006.19.1.51

Abstract

BACKGROUND: A cervical transforaminal steroid injection is an effective therapeutic modality for radiculopathy of a herniated cervical disc or a cervical foraminal stenosis. However, there is some debate regarding the safety of the transforaminal approach under C-arm guidance compared with the posterior interlaminar approach. We report a new technique for cervical transforaminal steroid injection guided by MDCT.
METHODS
Patients presenting with radiating pain on their shoulder or arm were diagnosed using CT or MRI of a cervical herniated disc or a foraminal stenosis. Each patient whose symptoms were compatible with the image scan was enrolled in this study. They received a cervical transforaminal steroid injection under CT guidance, and the effectiveness and complications of this technique were evaluated over a 2-month period.
RESULTS
According to the CT scan, none of the participants had an internal jugular vein or a carotid artery invasion during the procedure. No vertebral artery injection was noted, and no patient developed a hematoma after the injection. The VAS score had improved significantly by 2, 4 and 8 weeks after the injection.
CONCLUSIONS
While a conventional C-arm guided cervical transforaminal steroid injection does not appear to differentiate between the major vessels and structures in images, a CT guided approach is a more useful and safer technique for the precise placement of a needle.

Keyword

CT (Computed Tomography); herniated cervical disc; spinal stenosis; transforaminal steroid injection

MeSH Terms

Arm
Carotid Arteries
Constriction, Pathologic
Follow-Up Studies*
Hematoma
Humans
Intervertebral Disc Displacement
Jugular Veins
Magnetic Resonance Imaging
Needles
Radiculopathy
Shoulder
Spinal Stenosis
Tomography, X-Ray Computed
Vertebral Artery