Cargando…

Dispersal Pattern of Injectate After Cervical Epidural Steroid Injection Evaluated With Magnetic Resonance Imaging

STUDY DESIGN: Prospective, nonrandomized, clinical study. OBJECTIVE: Epidural steroid injections (ESIs) are an important diagnostic and treatment modality for spine pathology. The success of these injections has been attributed to the anatomic location reached by the injectate. This study evaluates...

Descripción completa

Detalles Bibliográficos
Autores principales: Goldstein, Christina L., Pashuck, Troy D., Ingalls, Kevin L., Billings, Laura L., Agha, Mohammad T., Drymalski, Mark W., Choma, Theodore J., Jeffries, Joel T., James, Christopher R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6562211/
https://www.ncbi.nlm.nih.gov/pubmed/31218197
http://dx.doi.org/10.1177/2192568218811141
_version_ 1783426252020908032
author Goldstein, Christina L.
Pashuck, Troy D.
Ingalls, Kevin L.
Billings, Laura L.
Agha, Mohammad T.
Drymalski, Mark W.
Choma, Theodore J.
Jeffries, Joel T.
James, Christopher R.
author_facet Goldstein, Christina L.
Pashuck, Troy D.
Ingalls, Kevin L.
Billings, Laura L.
Agha, Mohammad T.
Drymalski, Mark W.
Choma, Theodore J.
Jeffries, Joel T.
James, Christopher R.
author_sort Goldstein, Christina L.
collection PubMed
description STUDY DESIGN: Prospective, nonrandomized, clinical study. OBJECTIVE: Epidural steroid injections (ESIs) are an important diagnostic and treatment modality for spine pathology. The success of these injections has been attributed to the anatomic location reached by the injectate. This study evaluates injectate dispersal patterns after cervical interlaminar ESI using magnetic resonance imaging (MRI). METHODS: Patients between the ages of 18 and 85 years with cervical radiculopathy were identified. After obtaining consent for study participation, a gadolinium-enhanced cervical ESI was administered via an interlaminar approach under fluoroscopic guidance. Study participants underwent a cervical spine MRI within 15 minutes of administering the injection. Craniocaudal dispersal and the presence or absence of circumferential dispersal was assessed. RESULTS: The injectate dispersed a mean of 8.11 cm in the cranial direction, 6.63 cm in the caudal direction, and 360° circumferentially. No adverse events related to the ESI were reported. CONCLUSIONS: Fluoroscopy-guided cervical interlaminar ESI resulted in nearly uniform circumferential dispersal within the epidural space with multilevel migration in the cranial and caudal directions. MRI is a safe and accurate tool to evaluate spinal injectate dispersal.
format Online
Article
Text
id pubmed-6562211
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-65622112019-06-19 Dispersal Pattern of Injectate After Cervical Epidural Steroid Injection Evaluated With Magnetic Resonance Imaging Goldstein, Christina L. Pashuck, Troy D. Ingalls, Kevin L. Billings, Laura L. Agha, Mohammad T. Drymalski, Mark W. Choma, Theodore J. Jeffries, Joel T. James, Christopher R. Global Spine J Original Articles STUDY DESIGN: Prospective, nonrandomized, clinical study. OBJECTIVE: Epidural steroid injections (ESIs) are an important diagnostic and treatment modality for spine pathology. The success of these injections has been attributed to the anatomic location reached by the injectate. This study evaluates injectate dispersal patterns after cervical interlaminar ESI using magnetic resonance imaging (MRI). METHODS: Patients between the ages of 18 and 85 years with cervical radiculopathy were identified. After obtaining consent for study participation, a gadolinium-enhanced cervical ESI was administered via an interlaminar approach under fluoroscopic guidance. Study participants underwent a cervical spine MRI within 15 minutes of administering the injection. Craniocaudal dispersal and the presence or absence of circumferential dispersal was assessed. RESULTS: The injectate dispersed a mean of 8.11 cm in the cranial direction, 6.63 cm in the caudal direction, and 360° circumferentially. No adverse events related to the ESI were reported. CONCLUSIONS: Fluoroscopy-guided cervical interlaminar ESI resulted in nearly uniform circumferential dispersal within the epidural space with multilevel migration in the cranial and caudal directions. MRI is a safe and accurate tool to evaluate spinal injectate dispersal. SAGE Publications 2019-03-04 2019-06 /pmc/articles/PMC6562211/ /pubmed/31218197 http://dx.doi.org/10.1177/2192568218811141 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Goldstein, Christina L.
Pashuck, Troy D.
Ingalls, Kevin L.
Billings, Laura L.
Agha, Mohammad T.
Drymalski, Mark W.
Choma, Theodore J.
Jeffries, Joel T.
James, Christopher R.
Dispersal Pattern of Injectate After Cervical Epidural Steroid Injection Evaluated With Magnetic Resonance Imaging
title Dispersal Pattern of Injectate After Cervical Epidural Steroid Injection Evaluated With Magnetic Resonance Imaging
title_full Dispersal Pattern of Injectate After Cervical Epidural Steroid Injection Evaluated With Magnetic Resonance Imaging
title_fullStr Dispersal Pattern of Injectate After Cervical Epidural Steroid Injection Evaluated With Magnetic Resonance Imaging
title_full_unstemmed Dispersal Pattern of Injectate After Cervical Epidural Steroid Injection Evaluated With Magnetic Resonance Imaging
title_short Dispersal Pattern of Injectate After Cervical Epidural Steroid Injection Evaluated With Magnetic Resonance Imaging
title_sort dispersal pattern of injectate after cervical epidural steroid injection evaluated with magnetic resonance imaging
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6562211/
https://www.ncbi.nlm.nih.gov/pubmed/31218197
http://dx.doi.org/10.1177/2192568218811141
work_keys_str_mv AT goldsteinchristinal dispersalpatternofinjectateaftercervicalepiduralsteroidinjectionevaluatedwithmagneticresonanceimaging
AT pashucktroyd dispersalpatternofinjectateaftercervicalepiduralsteroidinjectionevaluatedwithmagneticresonanceimaging
AT ingallskevinl dispersalpatternofinjectateaftercervicalepiduralsteroidinjectionevaluatedwithmagneticresonanceimaging
AT billingslaural dispersalpatternofinjectateaftercervicalepiduralsteroidinjectionevaluatedwithmagneticresonanceimaging
AT aghamohammadt dispersalpatternofinjectateaftercervicalepiduralsteroidinjectionevaluatedwithmagneticresonanceimaging
AT drymalskimarkw dispersalpatternofinjectateaftercervicalepiduralsteroidinjectionevaluatedwithmagneticresonanceimaging
AT chomatheodorej dispersalpatternofinjectateaftercervicalepiduralsteroidinjectionevaluatedwithmagneticresonanceimaging
AT jeffriesjoelt dispersalpatternofinjectateaftercervicalepiduralsteroidinjectionevaluatedwithmagneticresonanceimaging
AT jameschristopherr dispersalpatternofinjectateaftercervicalepiduralsteroidinjectionevaluatedwithmagneticresonanceimaging