Multislice CT fluoroscopy-assisted cervical transforaminal injection of steroids: technical note

Cervical radiculopathy remains a common clinical challenge. Prior research has shown that transforaminal steroid injections can reduce nerve root inflammation. However, concerns about injection safety persist. Traditional C-arm fluoroscopy guidance has limitations in precision. No prior work had resolved how to improve accuracy while maintaining safety. This gap motivated exploring alternative imaging modalities. Multislice CT fluoroscopy offers enhanced visualization. It was already known that CT provides better anatomical detail than standard fluoroscopy. That uncertainty drove the need to evaluate this newer method's clinical utility.

The goal was to assess the safety and effectiveness of a new injection technique. This approach uses multislice CT fluoroscopy guidance. The specific problem is ensuring accurate needle placement in cervical foramina. The motivation stems from limitations of conventional fluoroscopy. The study aimed to determine if this method could reduce complications. It also sought to measure pain relief over time. Researchers focused on patients with confirmed radiculopathy. The study aimed to establish a feasible alternative to current practices.

Nineteen patients with cervical radiculopathy participated. They received up to three injections spaced at least two weeks apart. Multislice CT fluoroscopy guided needle placement. Imaging was performed using a dedicated CT system. Needle trajectory was monitored in real time. Injections targeted affected foramina based on MRI or CT findings. Safety was evaluated through complication tracking. Efficacy was measured using visual analog scale scores at multiple intervals.

No serious complications occurred during or after injections. Eleven patients received a second injection but none a third. Visual analog scale scores improved significantly at 2, 4, 8, and 16 weeks. The mean score decreased from 7.2 to 2.3 at week 16 (P < 0.001). These results suggest pain relief was sustained over the follow-up period. The technique demonstrated high procedural accuracy. Needle placement was confirmed with CT fluoroscopy images. Patients reported reduced radicular pain without adverse events.

The authors proposed that multislice CT fluoroscopy guidance is feasible. They suggested this method is safe for cervical injections. The technique may offer better precision than conventional fluoroscopy. The study found no evidence of increased risk with repeated injections. Pain relief was significant and lasted through the 16-week follow-up. The researchers proposed this could be an alternative to current methods. They suggested the technique might eventually replace standard fluoroscopy. No claims of necessity or essentiality were made in the abstract.