CT-guided cervical foraminal injection: Is a direct foraminal approach still necessary?

Details

Serval ID
serval:BIB_BD0DB3466CAC
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
CT-guided cervical foraminal injection: Is a direct foraminal approach still necessary?
Title of the conference
Swiss Radiological Congress 2010, Schweizerische Gesellschaft für Radiologie, Schweizerische Gesellschaft für Nuklearmedizin, Schweizerische Vereinigung der Fachleute für medizinisch technische Radiologie
Author(s)
Richarme D., Feydy A., Campagna R., Thévenin F., Guerini H., Chevrot A., Drapé J.L., Theumann N.
Address
Lugano, Switzerland, June 3-5, 2010
ISBN
1424-4985
Publication state
Published
Issued date
2010
Volume
10
Series
Swiss Medical Forum = Forum Médical Suisse
Pages
8
Language
english
Abstract
Purpose: Cervical foraminal injection performed with a direct foraminal
approach may induce serious neurologic complications. We describe a
technique of CT-guided cervical facet joint (CFJ) injection as an indirect
foraminal injection, including feasibility and diffusion pathways of the
contrast agent.
Methods and materials: Retrospective study included 84 punctures
in 65 consecutive patients presenting neck pain and/or radiculopathy
related to osteoarthritis or soft disc herniation. CT images were
obtained from C2 to T1 in supine position, with a metallic landmark on
the skin. CFJ punctures were performed by MSK senior radiologists with
a lateral approach. CT control of the CFJ opacification was performed
after injections of contrast agent (1 ml), followed by slow-acting
corticosteroid (25 mg). CFJ opacification was considered as successful
when joint space and/or capsular recess opacification occurred.
The diffusion of contrast agent in foraminal and epidural spaces was
recorded. We assessed the epidural diffusion both on axial and sagittal
images, with a classification in two groups (small diffusion or large
diffusion).
Results: CFJ opacification was successful in 82% (69/84). An epidural
and/or foraminal opacification was obtained in 74% (51/69). A foraminal
opacification occurred in 92% (47/51) and an epidural opacification in
63% (32/51), with small diffusion in 47% (15/32) and large diffusion in
53% (17/32). No complication occurred.
Conclusion: CT- guided CFJ injection is easy to perform and safe.
It is most often successful, with a frequent epidural and/or foraminal
diffusion of the contrast agent. This technique could be an interesting
and safe alternative to foraminal cervical injection.
Create date
29/06/2010 15:05
Last modification date
20/08/2019 15:31
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