Comparison of Incidences of Intravascular Injection between Medial and Lateral Side Approaches during Traditional S1 Transforaminal Epidural Steroid Injection
Purpose. Intravascular injection rates are higher during traditional S1 transforaminal epidural steroid injection (TFESI) compared with lumbar transforaminal injection. We compared the incidences of intravascular injection between the medial and lateral approaches to the S1 foramen during S1 TFESI....
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Pain Research and Management |
| Online Access: | http://dx.doi.org/10.1155/2017/6426802 |
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| author | Sang Jun Park Shin Hyung Kim Seon Ju Kim Duck Mi Yoon Kyung Bong Yoon |
| author_facet | Sang Jun Park Shin Hyung Kim Seon Ju Kim Duck Mi Yoon Kyung Bong Yoon |
| author_sort | Sang Jun Park |
| collection | DOAJ |
| description | Purpose. Intravascular injection rates are higher during traditional S1 transforaminal epidural steroid injection (TFESI) compared with lumbar transforaminal injection. We compared the incidences of intravascular injection between the medial and lateral approaches to the S1 foramen during S1 TFESI. Materials and Methods. A total of 139 patients underwent one or more TFESIs (170 total injections). The patients received S1 TFESI by either medial or lateral side of S1 foramen under fluoroscopic anteroposterior view using digital subtraction method. The intravascular injection rates, epidural spread patterns, and contrast volumes required to reach the superior aspect of the L5-S1 intervertebral disc (SIVD) were compared between groups. Results. Intravascular injection rates during S1 TFESI were significantly lower in the medial approach compared with the lateral approach patients (4.9% versus 38.6%, resp., P<0.001). The medial approach group had more epidural spread to the L5-S1 SIVD than the lateral group (82.1% versus 58.8%, resp.); lower contrast volume amounts were required to extend the L5-S1 SIVD (1.46±0.48 versus 1.90±0.62, resp.). Conclusion. During S1 TFESI, approaching the needle towards the medial part of the S1 foramen may reduce intravascular injection risk. |
| format | Article |
| id | doaj-art-4f03462d7f7442e2a5d576961697249d |
| institution | Kabale University |
| issn | 1203-6765 1918-1523 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pain Research and Management |
| spelling | doaj-art-4f03462d7f7442e2a5d576961697249d2025-02-03T01:01:18ZengWileyPain Research and Management1203-67651918-15232017-01-01201710.1155/2017/64268026426802Comparison of Incidences of Intravascular Injection between Medial and Lateral Side Approaches during Traditional S1 Transforaminal Epidural Steroid InjectionSang Jun Park0Shin Hyung Kim1Seon Ju Kim2Duck Mi Yoon3Kyung Bong Yoon4Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of KoreaPurpose. Intravascular injection rates are higher during traditional S1 transforaminal epidural steroid injection (TFESI) compared with lumbar transforaminal injection. We compared the incidences of intravascular injection between the medial and lateral approaches to the S1 foramen during S1 TFESI. Materials and Methods. A total of 139 patients underwent one or more TFESIs (170 total injections). The patients received S1 TFESI by either medial or lateral side of S1 foramen under fluoroscopic anteroposterior view using digital subtraction method. The intravascular injection rates, epidural spread patterns, and contrast volumes required to reach the superior aspect of the L5-S1 intervertebral disc (SIVD) were compared between groups. Results. Intravascular injection rates during S1 TFESI were significantly lower in the medial approach compared with the lateral approach patients (4.9% versus 38.6%, resp., P<0.001). The medial approach group had more epidural spread to the L5-S1 SIVD than the lateral group (82.1% versus 58.8%, resp.); lower contrast volume amounts were required to extend the L5-S1 SIVD (1.46±0.48 versus 1.90±0.62, resp.). Conclusion. During S1 TFESI, approaching the needle towards the medial part of the S1 foramen may reduce intravascular injection risk.http://dx.doi.org/10.1155/2017/6426802 |
| spellingShingle | Sang Jun Park Shin Hyung Kim Seon Ju Kim Duck Mi Yoon Kyung Bong Yoon Comparison of Incidences of Intravascular Injection between Medial and Lateral Side Approaches during Traditional S1 Transforaminal Epidural Steroid Injection Pain Research and Management |
| title | Comparison of Incidences of Intravascular Injection between Medial and Lateral Side Approaches during Traditional S1 Transforaminal Epidural Steroid Injection |
| title_full | Comparison of Incidences of Intravascular Injection between Medial and Lateral Side Approaches during Traditional S1 Transforaminal Epidural Steroid Injection |
| title_fullStr | Comparison of Incidences of Intravascular Injection between Medial and Lateral Side Approaches during Traditional S1 Transforaminal Epidural Steroid Injection |
| title_full_unstemmed | Comparison of Incidences of Intravascular Injection between Medial and Lateral Side Approaches during Traditional S1 Transforaminal Epidural Steroid Injection |
| title_short | Comparison of Incidences of Intravascular Injection between Medial and Lateral Side Approaches during Traditional S1 Transforaminal Epidural Steroid Injection |
| title_sort | comparison of incidences of intravascular injection between medial and lateral side approaches during traditional s1 transforaminal epidural steroid injection |
| url | http://dx.doi.org/10.1155/2017/6426802 |
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