The Fluoroscopic-Guided Cervical Transarticular Epidural Steroid Injection

Area of Science:

• Pain Management
• Neurosurgery
• Radiology

Background:

• The epidural space is typically accessed via interlaminar or transforaminal routes for corticosteroid delivery.
• Radicular pain management often involves epidural injections.
• A transarticular approach offers an alternative, particularly when standard methods are unsuitable.

Purpose of the Study:

• To describe a cervical transarticular epidural approach using fluoroscopic guidance.
• To review existing literature on computed tomography-guided transarticular injections in the cervical spine.
• To assess the safety profile of the transarticular epidural approach.

Main Methods:

• Description of a novel cervical transarticular epidural injection technique.
• Utilized fluoroscopic guidance for needle placement.
• Reviewed computed tomography-guided cervical transarticular epidural injection literature.

Main Results:

• Successfully described a fluoroscopic-guided cervical transarticular approach.
• Literature review indicated prior descriptions using computed tomography guidance.
• The transarticular approach, when performed carefully, avoids critical neurovascular structures, suggesting low risk.

Conclusions:

• The cervical transarticular epidural approach under fluoroscopy is a viable alternative for pain management.
• This technique may be advantageous when interlaminar or transforaminal routes are contraindicated.
• Prudent execution of this approach minimizes risks to the spinal cord, nerve roots, and vasculature.