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Performing thoracic transforaminal injections: a new technique.

Humberto G Rosas1, Louis A Gilula

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This study evaluated a fluoroscopically guided technique for thoracic epidural injections, demonstrating a low complication rate. The approach proved advantageous for patients with spinal abnormalities, enhancing safety and efficacy in thoracic interventions.

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Area of Science:

  • Pain Management
  • Interventional Radiology
  • Neurosurgery

Background:

  • Thoracic transforaminal epidural injections are utilized for pain management.
  • Previous techniques may carry risks of inadvertent injury to surrounding structures.
  • A refined technique aims to improve safety and efficacy.

Purpose of the Study:

  • To evaluate a fluoroscopically guided technique for thoracic transforaminal epidural injections.
  • To assess the safety and complication profile of this specific approach.
  • To compare the technique's advantages in challenging patient populations.

Main Methods:

  • Retrospective review of 198 thoracic foraminal nerve blocks and epidural injections.
  • Utilized fluoroscopic spot views for technique evaluation.
  • Focused on a technique designed to minimize injury to non-targeted structures.

Main Results:

  • A single delayed pneumothorax occurred due to deviation from the technique.
  • No major complications such as death, neurovascular injury, or infection were reported.
  • The technique facilitated needle placement in patients with osteopenia, osteoarthritis, and scoliosis.

Conclusions:

  • The evaluated technique for fluoroscopically guided thoracic intraforaminal nerve blocks is associated with few complications.
  • This approach anatomically avoids structures in the posterior mediastinum.
  • The technique offers advantages for specific patient groups requiring thoracic epidural injections.