The Fluoroscopic-Guided Cervical Trans-Articular Epidural Steroid Injection: A Case Report.

Journal: American Journal Of Physical Medicine & Rehabilitation

The epidural space is commonly accessed via an interlaminar or transforaminal approach in order to administer corticosteroids for radicular pain. An alternative is a trans-articular approach, which may be considered when conventional access to the epidural space is either not desired or contraindicated. This approach has been described in the cervical spine using computed tomography guidance but not fluoroscopic guidance. We describe a cervical trans-articular approach to the epidural space under fluoroscopy and review the computed tomography-guided literature. The risks of trans-articular epidural injections are likely low given that, when performed prudently, they avoid direct contact with the vertebral artery, spinal medullary arteries, venous plexus, spinal cord, and nerve roots.

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