Sequential fluoroscopic images demonstrate optimal needle placement (A and B) and contrast injection (C and D). Sequential fluoroscopic images demonstrate.

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Presentation transcript:

Sequential fluoroscopic images demonstrate optimal needle placement (A and B) and contrast injection (C and D). Sequential fluoroscopic images demonstrate optimal needle placement (A and B) and contrast injection (C and D). A, Approximately 45° oblique projection, with slight caudal-to-cephalad orientation of the fluoroscopy axis, is centered on the lower lateral aspect of right C5–6 foramen. Needle tip (arrow) is in contact with the posterior wall of nerve root canal. B, AP image shows the needle tip (arrow) optimally positioned in the lower lateral aspect of right C5–6 neural foramen, with the needle tip contacting bone. C and D, Approximately 45° oblique (C) and AP (D) images obtained after injection of approximately 1.5 mL of contrast. The right C5 nerve root is outlined by contrast. Epidural reflux at C5 (small arrow) and C6 (larger arrow) is clearly demonstrated in D. This case represents an optimal degree of opacification for a therapeutic blockade, in which epidural reflux is desired. K.P. Schellhas et al. AJNR Am J Neuroradiol 2007;28:1909-1914 ©2007 by American Society of Neuroradiology