Journal of Yeungnam Medical Science

Original article

Digital subtraction angiography vs. real-time fluoroscopy for detection of intravascular injection during transforaminal epidural block: Kibeom Park, Saeyoung Kim; Yeungnam Univ J Med. 2019;36(2):109-114. Published online January 24, 2019; DOI: https://doi.org/10.12701/yujm.2019.00122

5,312 View
94 Download
5 Crossref

Background
Transforaminal epidural block (TFEB) is an effective treatment option for radicular pain. To reduce complications from intravascular injection during TFEB, use of imaging modalities such as real-time fluoroscopy (RTF) or digital subtraction angiography (DSA) has been recommended. In this study, we investigated whether DSA improved the detection of intravascular injection during TFEB at the whole spine level compared to RTF.
Methods
We prospectively examined 316 patients who underwent TFEB. After confirmation of final needle position using biplanar fluoroscopy, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under RTF; 30 s later, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under DSA.
Results
Thirty-six intravascular injections were detected for an overall rate of 11.4% using RTF, with 45 detected for a rate of 14.2% using DSA. The detection rate using DSA was statistically different from that using RTF (p=0.004). DSA detected a significantly higher proportion of intravascular injections at the cervical level than at the thoracic (p=0.009) and lumbar (p=0.011) levels.
Conclusion
During TFEB at the whole spine level, DSA was better than RTF for the detection of intravascular injection. Special attention is advised for cervical TFEB, because of a significantly higher intravascular injection rate at this level than at other levels.

Citations

Citations to this article as recorded by

1. Lumbosacral radicular pain
Laurens Peene, Steven P. Cohen, Jan Willem Kallewaard, Andre Wolff, Frank Huygen, Antal van de Gaag, Steegers Monique, Kris Vissers, Chris Gilligan, Jan Van Zundert, Koen Van Boxem
Pain Practice.2024; 24(3): 525. CrossRef
Safety of local anesthetics in cervical nerve root injections: a narrative review
Zachary E. Stewart
Skeletal Radiology.2023; 52(10): 1893. CrossRef
An update on technical and safety practice patterns in transforaminal epidural steroid injections
Ashley E. Gureck, Berkenesh Gebrekristos, Razvan Turcu, Dana Kotler, Alec L. Meleger
Interventional Pain Medicine.2023; 2(4): 100286. CrossRef
Thoracic transforaminal epidural steroid injection for management of thoracic spine pain: A multicenter cross-sectional study of short-term outcomes
Josh Levin, John Chan, Lisa Huynh, Matt Smuck, Jayme Koltsov, Bilge Kesikburun, Graham E. Wagner, Marc Caragea, Keith Kuo, Zachary L. McCormick, Byron Schneider, Evan Berlin, D.J. Kennedy, Serdar Kesikburun
Interventional Pain Medicine.2022; 1(1): 100004. CrossRef
The American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain
Mansoor M Aman, Ammar Mahmoud, Timothy Deer, Dawood Sayed, Jonathan M Hagedorn, Shane E Brogan, Vinita Singh, Amitabh Gulati, Natalie Strand, Jacqueline Weisbein, Johnathan H Goree, Fangfang Xing, Ali Valimahomed, Daniel J Pak, Antonios El Helou, Priyanka
Journal of Pain Research.2021; Volume 14: 2139. CrossRef

Original Article

Utility of H-reflex in the Diagnosis Cervical Radiculopathy.: Jun Lee, Gun Ju Park, Hyun Cheol Doo, Sung Geon Park, Yun Seog Jeong, Jung Sang Hah; Yeungnam Univ J Med. 1997;14(1):111-122. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.111

1,794 View
23 Download
3 Crossref

Abstract PDF

H-reflex is a kind of late respons which can be used for the proximal nerve conduction study. Also it is a useful and widely used nerve conduction technique es to look electrically at the monosynaptic reflex. Although recordable from all muscles theoretically, H-reflexes are most commonly recorded from the calf muscles following stimulation of the tibial nerve in the popliteal fossa. But in this study, We tried to establish the normal data and to evaluate the significance of the H-reflex study in cervical radiculopathy. H-reflexes were recorded from flexor carpi radialis (FCR) muscle, extensor carpi radialis (ECR) muscle, brachioradialis (BR) muscle, and abductor digiti minimi (ADM) muscle in 31 normal adults (62 cases) and 12 patients with cervical radiculopathy. The mean values of H-reflex latency in normal control group were 16.16+/- 1.65 msec in FCR; 15.99+/- 1.25 msec in ECR; 16.47+/- 1.59 msec in BR; 24.46+/- 1.42 msec in ADM. And the mean values of side to side difference of H-reflex latency were 0.47+/- 0.48 msec in FCR; 0.68+/- 0.72 msec in ECR; 0.63+/- 0.43 msec in BR; 22.31+/- 1.24 msec in ADM. Mean values of side to side differences of interlatency time were 0.49+/-0.47 msec in FCR; 0.73+/- 0.62 msec in ECR; 0.79+/- 0.71 msec in BR; 0.69+/- 0.44 msec in ADM. Also, there were no significant differences in H-reflex latency between right and left side. H-reflex tests in patient group with cervical radiculopathy revealed abnormal findings in 11 out of 12 patients. These results suggest that H-reflex in the upper extremity would be helpful in the diagnosis of the cervical radiculopathy.

Citations

Citations to this article as recorded by

Retraining Reflexes: Clinical Translation of Spinal Reflex Operant Conditioning
Amir Eftekhar, James J.S. Norton, Christine M. McDonough, Jonathan R. Wolpaw
Neurotherapeutics.2018; 15(3): 669. CrossRef
Abnormal Flexor Carpi Radialis H-Reflex as a Specific Indicator of C7 as Compared With C6 Radiculopathy
Chaojun Zheng, Yu Zhu, Feizhou Lv, Xiaosheng Ma, Xinlei Xia, Lixun Wang, Xiang Jin, Robert Weber, Jianyuan Jiang, Kevin Anuvat
Journal of Clinical Neurophysiology.2014; 31(6): 529. CrossRef
Utility of Flexor Carpi Radialis H-Reflex in Diagnosis of Cervical Radiculopathy
Dariush Eliaspour, Ehsan Sanati, Mohammad Reza Hedayati Moqadam, Seyed Mansoor Rayegani, Mohammad Hasan Bahrami
Journal of Clinical Neurophysiology.2009; 26(6): 458. CrossRef

First
Prev
Page of 1
Next
Last

Search