A comparison of contrast patterns of lumbar transforaminal injection in terms of volume

BACKGROUNDS: Lumbar transforaminal epidural injections(LTEIs) have been widely utilized in the treatment of radicular pain. LTEIs is considered to be most target-specific with the least volume in fulfilling the aim of reaching the primary site of pathology. However, there have been no studies on the proper volume of injection needed in LTEIs. We studied the contrast spreading patterns after LTEIs with 1 ml, 2 ml, 3 ml of the contrast media and normal saline. METHODS: A total of 65 patients with spine or non-spine diseases were selected. Fluoroscopic guided LTEIs were performed consecutively with 1 ml(n=16) and 2 ml(n=17) and 3 ml(n=32) volume of mixture containing 2 ml of Iopaminol (0.7552 g/ml) and 1 ml of normal saline. Patterns were recorded as a nerve root filling, a nerve root filling with unilateral epidural spreding or a nerve root filling with bilateral or cylinderic epidural spreading. A number of vertebral spreading segments of contrast media cephalad and caudad were recorded as well. RESULT: Total vertebral spreading segments of contrast media were not significantly different between each group. The number of patients that the contrast flow was limited to the targeted single vertebral level was significantly higher in 1 ml and 2 ml group than in 3 ml group. There was no difference in the number of patients with only nerve root filling between the three groups. Only four patients (6.1%) out of total showed the only nerve root filling. Most of the patients in 1 ml and 2 ml groups showed nerve root filling with unilateral epidural spreading. The number of patients with nerve root filling with bilateral epidural spreading pattern was not significantly different between the three groups, however, higher number of the group 3 patients revealed this pattern. CONCLUSION: An injectate volume of less than or equal to 2ml is proper volume that can spread selectively onto the targeted single nerve root and ipsilateral epidural space of pathologic segmental level in LTEI. An injectate volume of less than 1.0 ml is needed when performing diagnostic LTEIs in which selective spread of injectate around targeted nerve root only should be obtained.

Author dc:creator

• 조, 혜원

Contributors dc:contributor

• 김, 찬
• 대학원 의학과
• 200824376

• 요추 경추간공 경막외강 약물주입
• 용량
• 조영상

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000010349
000000010349

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1775