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Fluoroscopic contralateral oblique view in interlaminar interventions: a technical note.

Michael B Furman, Michael Furman1, Nicholas R Jasper

  • 1Orthopaedic and Spine Specialists, 1855 Powder Mill Road, York, PA 17402, USA. mbfurman@gmail.com

Pain Medicine (Malden, Mass.)
|September 22, 2012
PubMed
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The contralateral oblique (CLO) view enhances needle visualization during cervical, thoracic, and lumbar interlaminar procedures. This technique improves accuracy, especially in challenging anatomies, for epidural steroid injections and spinal cord stimulation lead placement.

Area of Science:

  • Interventional Pain Management
  • Spinal Procedures
  • Medical Imaging

Background:

  • Cervical, thoracic, and lumbar interlaminar procedures are common for pain management.
  • Accurate needle placement is crucial for efficacy and safety.
  • Standard fluoroscopic views can be limited by patient anatomy and positioning.

Purpose of the Study:

  • To evaluate the utility of the contralateral oblique (CLO) view in interlaminar procedures.
  • To demonstrate how CLO views improve visualization of spinal anatomy and needle tip.
  • To recommend the use of CLO views for enhanced procedural safety and accuracy.

Main Methods:

  • Utilized fluoroscopic imaging to illustrate the CLO view technique.
  • Described the process of obtaining CLO views relative to the needle tip.

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  • Highlighted visualization of the interlaminar space and spinolaminar line.

    • Main Results:

    • The CLO view provides clearer visualization of the needle traversing the lamina.
    • It aids in accurate needle tip placement towards the spinolaminar line.
    • Improved visualization is noted in cases with difficult patient positioning or body habitus.

    Conclusions:

    • The CLO view is recommended for thoracic and lumbar interlaminar procedures, complementing cervical applications.
    • Combining CLO and anterior-posterior views offers safe, multi-planar imaging.
    • CLO views are particularly valuable when standard lateral views lack clarity.