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Updated: Jan 17, 2026
Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Comparison of Magnetic Resonance Imaging and Intraprocedural Cervical Epidural Depth: A Case Series
Steven Kim1, Kimberly Fazio2, Vlad Suric3
1Department of Pain Medicine, Physical Medicine and Rehabilitation, MetroHealth/Case Western Reserve University, Cleveland, OH.
Background:
Cervical epidural depth is assessed intraprocedurally using loss-of-resistance technique and fluoroscopy. It would be helpful if this depth could be predicted using magnetic resonance imaging (MRI) images.
Methods:
This is a case series of 10 patients undergoing cervical epidural steroid injections (CESIs). The following measurements were made: intraprocedural depth, measured on Tuohy needles intraprocedurally, and MRI depth, measured from the MRI cervical spine. Linear regression models were used to compare the 2 depths.
Results:
For intraprocedural depth vs sagittal MRI depth, R (Version 4.2.0, R Foundation for Statistical Computing, Vienna, Austria, 2021) was 0.8744, P value < 0.0001. For intraprocedural depth vs axial MRI depth, R was 0.8582, P value < 0.001.
Conclusions:
Knowledge of the cervical epidural depth prior to CESIs may improve the safety and efficacy of these procedures.
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