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Multislice CT Fluoroscopy-assisted Cervical Transforaminal Injection of Steroids: Technical Note

Kim, Hoondo MD*; Lee, Sang-Ho MD, PhD; Kim, Myung-Ho RT

doi: 10.1097/BSD.0b013e318030d2bc
Original Articles

Study Design A prospective study of 19 consecutive patients who underwent multislice computed tomography (CT)-guided cervical transforaminal steroid injection.

Objective To evaluate the feasibility and the outcome of cervical transforaminal steroid injection guided by multislice CT fluoroscopy.

Summary of Background Data Cervical transforaminal steroid injection has been accepted as an effective therapeutic modality for radiculopathy that results from a cervical herniated disc or stenosis. However, there has been debate on the safety of the transforaminal approach technique, with C-arm fluoroscopy guidance, compared with the posterior interlaminar approach. We present an advanced approach technique for cervical transforaminal steroid injection guided by multislice CT fluoroscopy and the clinical outcomes.

Methods Nineteen consecutive patients presenting with radiating pain to the shoulder or arm had CT or magnetic resonance image scan findings compatible with cervical herniated disc or foraminal stenosis and were recruited to participate in this study. They underwent cervical transforaminal steroid injection using multislice CT fluoroscopy guidance up to 3 times with a minimal interval of 2 weeks. The participants were evaluated for the safety and efficacy of this technique for a follow-up period of 16 weeks.

Results No serious complications were found during and after the procedures. Eleven patients received a second steroid injection but none required a third injection over the 16-week follow-up period. The mean visual analog scale score improved significantly at 2, 4, 8, and 16 weeks (P<0.001).

Conclusions The multislice CT fluoroscopy-guided approach is feasible and a safe and effective approach for cervical transforaminal steroid injection. With the advantages of safety for the patient and precise placement of the needle for injection, this technique might be an additional option and may eventually replace the conventional C-arm fluoroscopy-guided cervical transforaminal steroid injection technique.

Departments of *Anesthesiology and Pain Medicine


Radiology, Gimpo Airport Wooridul Spine Hospital, Seoul, Korea

Supported by a grant from the Wooridul Spine Foundation.

Reprints: Hoondo Kim, MD, 272-28 Gwahae-Dong Gangseo-Gu, Seoul 157-822, Korea (e-mail:

Received for publication August 1, 2006; accepted December 3, 2006

© 2007 Lippincott Williams & Wilkins, Inc.