Stemcelldoc's Weblog

August 13, 2013

Cervial Epidural Injections: Insist Upon X-ray guidance

At the Centeno-Schultz Clinic patient safety is paramount.

Cervical epidural injections are utilized to diagnose and treat neck and arm pain arising from the cervical spine.

Not all cervical epidural injections are performed in the similar fashion.

Some use x-ray guidance (fluoroscopy with injection of contrast) and others perform the injection without x-ray (blind).

Is there a difference?

Yes

c-arm_fluoroscopy

X-ray is used to guide and confirm the accurate placement of the needle into the epidural space.

Complications associated with not using x-ray:

Spinal nerve injury

Spinal hematoma

Injection into the spinal fluid with onset of hypotension and respiratory arrest.

Spinal cord injury.

Postdural headaches.

Vasovagal reaction.

X-ray also enables the injection of contrast (dye) to demonstrate the location and flow of medication injected.  If flow is limited to the right and the patient has pain only on the left the injection most likely will fail.  X-ray guidance documents the flow of contrast to maximize clinical results.  All cervical injections at the Centeno-Schultz Clinic utilize x-ray guidance.

Cervical-Interlaminar-Epidural-Steroid-Injection-post-contrast

Cervical epiduralw are useful in the treatment of neck and arm pain but require the use of intermittent x-ray (fluoroscopy) to minimize the significant potential complications and maximize clinical outcome.  This is the standard of care at the Centeno-Schultz Clinic.

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