게시판
| 21KS-031 |
Comparison of Radiation Exposure between Interlaminar and Transforaminal Epidural Injection for Cervical Radicular Pain
Department
of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute,
Yonsei University College of Medicine, Seoul, Republic of Korea
Background
Fluoroscopy-guided epidural injection is widely performed in patients with cervical radicular pain. There are two approaches, interlaminar approach (IL) and transforaminal approach (TF), that might provide no significant difference in effect of cervical epidural block in previous studies. Other than studies that investigate effect, there is a paucity of research on radiation exposure. The main focus of this study was to determine the degree of radiation exposure between the two approaches.
Methods
This retrospective study explored radiation dose(dose area product, DAP) and exposure time of fluoroscopy-guided epidural injection between interlaminar approach and transforaminal approach performed on patients with cervical radicular pain. One-level cervical block and two-level cervical block using the transforaminal approach were compared to the interlaminar approach for analysis. The procedure was performed by a skilled anesthesiologist with more than five months of experience.
Results
Eighty cases were included for analysis with 37 patients in the interlaminar group (IL), 27patients in the one level transforaminal group (TF1) and 16 patients in the two level transforaminal group (TF2). DAP was significantly higher in the IL group compared to the TF1 group (201.2±211 vs 115.1±75.5 cGycm2; p=0.006). However, the radiation dose was comparable between TF2 and IL group. The radiation exposure time showed no significant difference for all three groups.
Conclusion
In this study, the radiation dose was higher in the IL approach than 1 level TF approach for cervical radicular pain. Through this study, it may be a reference to which block is better in terms of radiation exposure risk.
Keywords: Epidural, cervical, interlaminar, transforaminal, fluoroscopy, radiation
Fluoroscopy-guided epidural injection is widely performed in patients with cervical radicular pain. There are two approaches, interlaminar approach (IL) and transforaminal approach (TF), that might provide no significant difference in effect of cervical epidural block in previous studies. Other than studies that investigate effect, there is a paucity of research on radiation exposure. The main focus of this study was to determine the degree of radiation exposure between the two approaches.
Methods
This retrospective study explored radiation dose(dose area product, DAP) and exposure time of fluoroscopy-guided epidural injection between interlaminar approach and transforaminal approach performed on patients with cervical radicular pain. One-level cervical block and two-level cervical block using the transforaminal approach were compared to the interlaminar approach for analysis. The procedure was performed by a skilled anesthesiologist with more than five months of experience.
Results
Eighty cases were included for analysis with 37 patients in the interlaminar group (IL), 27patients in the one level transforaminal group (TF1) and 16 patients in the two level transforaminal group (TF2). DAP was significantly higher in the IL group compared to the TF1 group (201.2±211 vs 115.1±75.5 cGycm2; p=0.006). However, the radiation dose was comparable between TF2 and IL group. The radiation exposure time showed no significant difference for all three groups.
Conclusion
In this study, the radiation dose was higher in the IL approach than 1 level TF approach for cervical radicular pain. Through this study, it may be a reference to which block is better in terms of radiation exposure risk.
Keywords: Epidural, cervical, interlaminar, transforaminal, fluoroscopy, radiation