Dispersal Pattern of Injectate after Lumbar Interlaminar Epidural Spinal Injection Evaluated with Computerized Tomography

Study Design Retrospective analysis of lumbar computed tomographic epidurograms. Objective To evaluate the dispersal pattern of injectate after interlaminar lumbar epidural steroid injections. Summary Prior studies have evaluated the dispersal patterns of injectate after lumbar epidural steroid injections using fluoroscopy with varying results. To date, there have been no studies evaluating the dispersal pattern utilizing computerized tomography. Methods Ten epidurograms were analyzed after lumbar interlaminar epidural steroid injection. The epidurograms were examined, evaluating the dispersal pattern in longitudinal flow as well as circumferential flow. In addition, pain values were assessed with the visual analogue scale. Results Mean diffusion in the rostral direction was 9.8 cm (standard deviation 4.0 cm, range 4.0 to 15.0 cm). Mean diffusion in the caudal direction was 5.4 cm (standard deviation 1.4 cm, range 3.0 to 8.0 cm). Both rostral and caudal flow had a p value < 0.001. The circumferential flow was 360 degrees in 9 of 10 cases. In addition, there was significant (p = 0.006) reduction in pain. Conclusion Interlaminar lumbar epidural steroid injections are an effective treatment modality for various spine-related conditions. The injectate diffuses throughout the epidural space with nearly uniform circumferential flow as well as significant rostral and caudal flow.

• Publication year

  2012

• Venue

  Global Spine Journal

• Publication date

  2012-03-01

• Fields of study

  Medicine, Computer Science

• Identifiers
  DOI 10.1055/s-0032-1307251PMID 24353943PMCID 3864458
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Evaluation of Epidurographic Contrast Patterns with Fluoroscopic‐Guided Lumbar Interlaminar Ventral Epidural Injection

  2009cited by this paper
• Fluoroscopic analysis of lumbar epidural contrast spread after lumbar interlaminar injection.

  2008cited by this paper
• A Prospective Evaluation of Iodinated Contrast Flow Patterns with Fluoroscopically Guided Lumbar Epidural Steroid Injections: The Lateral Parasagittal Interlaminar Epidural Approach Versus the Transforaminal Epidural Approach

  2008cited by this paper
• Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain.

  2007cited by this paper
• Influence of needle tip position on injectate spread in 406 interlaminar lumbar epidural steroid injections.

  2007cited by this paper
• Fluoroscopic guided lumbar interlaminar epidural injections: a prospective evaluation of epidurography contrast patterns and anatomical review of the epidural space.

  2004cited by this paper
• Paralysis after transforaminal epidural injection and previous spinal surgery

  2004cited by this paper
• Paraplegia after lumbosacral nerve root block: report of three cases.

  2002cited by this paper
• Friday, November 1, 2001 3:45– 4:28 pm Concurrent Session 3A: Deformity Techniques

  2002cited by this paper
• Fluoroscopic transforaminal lumbar epidural steroids: an outcome study.

  1998cited by this paper
• Radiographic investigation of unilateral epidural block after single injection.

  1997cited by this paper
• Radiographic Findings of Unilateral Epidural Block

  1996cited by this paper
• Inflammatogenic Properties of Nucleus Pulposus

  1995cited by this paper
• Human Disc Phospholipase A2 is Inflammatory

  1992cited by this paper
• Local corticosteroid application blocks transmission in normal nociceptive C‐fibres

  1990cited by this paper
• Clinical and radiologic evidence of the epidural plica mediana dorsalis.

  1990cited by this paper
• Corticosteroids inhibit prostaglandin production by rheumatoid synovia

  1975cited by this paper
• The spread of solutions injected into the epidural space. A study using epidurograms in patients with the lumbosciatic syndrome.

  1974cited by this paper
• [Hydrocortisone (compound F); first clinical experiments in the field of rheumatology].

  1952cited by this paper

• Author response to Letter to the Editor by Dr Aliper Mengi concerning Manuscript number: YMATH D-24-00535 "Anaesthetic and corticosteroid response immediately following epidural injection in patients with MRI confirmed lumbar disc herniation".

  2025cites this paper
• Web-based machine learning application for interpretable prediction of prolonged length of stay after lumbar spinal stenosis surgery: a retrospective cohort study with explainable AI

  2025cites this paper
• CT-Guided Caudal Epidural Infiltrations: A Technical Note

  2021cites this paper
• Distribution of a Solution in the Epidural Space

  2020cites this paper
• Lumbar Spinal Stenosis Severity by CT or MRI Does Not Predict Response to Epidural Corticosteroid versus Lidocaine Injections

  2019cites this paper
• Dispersal Pattern of Injectate After Cervical Epidural Steroid Injection Evaluated With Magnetic Resonance Imaging

  2019cites this paper
• Ultrasound-Assisted Lumbar Interlaminar Epidural Dye Injection and Evaluation of Its Distribution by Anatomical Dissection

  2019cites this paper
• Effectiveness of Bilateral Transforaminal Epidural Steroid Injections in Degenerative Lumbar Spinal Stenosis Patients With Neurogenic Claudication: A Case Series

  2017cites this paper