Optimal Angle of Contralateral Oblique View in Cervical Interlaminar Epidural Injection: Safety or Precision?

Response to Letter: Optimal Angle of Contralateral Oblique View in Cervical Interlaminar Epidural Injection: Safety or Precision?

Optimal Angle of Contralateral Oblique View in Cervical Interlaminar Epidural Injection Depending on the Needle Tip Position.

BACKGROUND Chronic neck and upper extremity pain associated with cervical origin is common, and cervical interlaminar epidural steroid injections (CILESIs) are frequently used to manage the symptoms of cervical spinal disorders. However, CILESIs are associated with risks such as dural puncture and cord injury. OBJECTIVES We aimed to determine the optimal needle tip visualization, in order to ...

Contralateral oblique view is superior to lateral view for interlaminar cervical and cervicothoracic epidural access.

OBJECTIVE The purpose of this study was to compare the reliability of the lateral fluoroscopic view and several contralateral oblique (CLO) views at different angles in visualizing and accurately predicting the position of the needle tip at the point of access in the posterior cervical and cervicothoracic epidural space. DESIGN After the epidural space was accessed but before confirmation wit...

Reliability and Safety of Contra-Lateral Oblique View for Interlaminar Epidural Needle Placement: Standardization of the Appropriate Angle.

In this large retrospective review of a clinical case, Derby et al (1) again show that the contralateral oblique (CLO) view is safe and accurate. Loss of resistance cannot be expected before the ventral interlaminar line (VILL) and the needle may be passed with impunity to just before this line. As the interlaminar line is accessed, the loss of resistance should occur immediately or shortly the...

Reliability and Safety of Contra-Lateral Oblique View for Interlaminar Epidural Needle Placement.

Cord trauma is a risk with a cervical and thoracic interlaminar epidural approach to the epidural space. Intermittent lateral fluoroscopic imaging to detect needle depth is often cumbersome and may be difficult to interpret. In comparison, the contra-lateral oblique (CLO) fluoroscopic view is efficient and easy to interpret. However, the in vivo reliability and safety of this technique has not ...