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Direct Visualization of Cervical Interlaminar Epidural Injections Using Sonography.

Nana Maeda¹, Manabu Maeda¹, Yasuhito Tanaka²

¹Maeda Orthopaedic Clinic, 864-1 Kidera-cho, Nara 630-8306, Japan.

Tomography (Ann Arbor, Mich.)

|July 27, 2022

Summary

This study introduces a new ultrasound-guided technique for cervical epidural steroid injections, simplifying needle placement and enhancing safety. This method offers a potentially easier and safer alternative for cervical epidural injections.

Keywords:

cervical epidural injection steroid superb microvascular imaging ultrasound

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Area of Science:

Pain Management
Radiology
Neurosurgery

Background:

Conventional cervical epidural steroid injections often rely on the loss-of-resistance method for epidural space identification.
This technique can be challenging and may lead to complications.

Observation:

A novel ultrasound (US)-guided cervical interlaminar epidural steroid injections (CILESIs) procedure was developed.
The technique involves identifying three US-visible structures: the interspinal ligament, ligamentum flavum, and dura mater (triple bar sign).
Injectants were monitored using superb microvascular imaging.

Findings:

The US-guided CILESIs procedure was successfully demonstrated in nine cases.
This sonographic approach eliminates the need for the loss-of-resistance method.
Direct visualization via sonography allows for easier and safer cervical epidural injections.

Implications:

Ultrasound guidance offers a potentially safer and more accessible method for cervical epidural injections.
This technique may facilitate outpatient cervical epidural injection procedures.
Sonography can improve the precision and safety of epidural steroid delivery in the cervical spine.