CT fluoroscopic-guided cervical nerve root blocks

Abstract

While both fluoroscopic and CT-guidance during cervical nerve root blocks have been well documented in the literature, the use of CT fluoroscopy (CTF) has not. CTF is well suited to provide imaging guidance during these procedures due to its combination of excellent anatomic detail, relatively low radiation dose and the ability to perform an initial dynamic contrast injection, and is a viable alternative to fluoroscopic guidance. Details of the technique along with the initial experience at one institution are presented.

Figures

Fig 1.

Axial CT fluorscopic image demonstrates the approach used to access the neural foramen. Needle tip is located along the posterior foramen, well away from the vertebral vessels but directly adjacent to the exiting nerve root.

Fig 2.

After its injection, the contrast material is noted to travel along the posterior aspect of the nerve root within the neural foramen. In many cases, transforaminal contrast enhancement is not seen, as the material stays around the ganglion and extraforaminal nerve.