Advantages of Digital Subtraction Angiography During Nerve Block

INTRODUCTION: Most pain physicians know that fluoroscopy might improve the safety, accuracy, and efficacy of nerve block; however, it is difficult to distinguish the previously administered contrast medium from the injecting contrast medium, and to identify accurate contrast medium diffusion flow in a case of existing radiodensities such as cement and screw. Digital subtraction angiography (DSA) can improve accuracy of nerve blocks. CASE PRESENTATION: We described our experiences with two successful transforaminal epidural injections and nerve block of two patients with 73 and 68 years of age who were diagnosed as failed back surgery syndrome. CONCLUSIONS: The advantages of DSA in fluoroscopy-guided transforaminal epidural block and nerve block are identification of the degree of appropriate contrast flow (epidural and nerve root sleeve) and the intravascular administration without overlapping radiodense structures.