BACKGROUND AND PURPOSE: Cervical steroid injections are a minimally invasive means of providing pain relief to patients with cervical radiculopathy. CT guidance offers many potential advantages. We developed a technique with the patient in the lateral position with a lateral needle trajectory to minimize the required needle depth from skin to target and a near-vertical needle trajectory. The aim of this study was to analyze the cohort for complications, procedural time, and effective radiation dose. MATERIALS AND METHODS: This was a retrospective evaluation of a single-center patient cohort. PACS images from the procedures were reviewed for needle depth, procedural time, and CTDI(vol). An anatomically relevant conversion factor was used to calculate the effective dose. RESULTS: One hundred sixteen cases from 110 patients were identified. The average patient age was 55 years. There were no complications. In 50% of cases, C5-6 was targeted. The average time was 6 minutes, and the average effective radiation dose, 0.51 mSv (0.21-2.56 mSv). Needle-insertion length from the skin to the target was highly correlated with a need for >3 needle repositioning adjustments and scan series (ρ = 0.52, P < .001) and increased procedural time (ρ = 0.42, P < .001). The angle of needle insertion relative to the floor was significantly correlated with an increased number of needle adjustments for depths >25 mm and a longer procedural time (ρ = 0.29, P = .01) but not for depths <25 mm. CONCLUSIONS: The lateral patient position with CT guidance is safe and allows use of a short needle in a vertical trajectory. This reduces the number of needle adjustments and imaging series to provide a short procedural time with a low effective radiation dose from the procedure.
BACKGROUND AND PURPOSE: Cervical steroid injections are a minimally invasive means of providing pain relief to patients with cervical radiculopathy. CT guidance offers many potential advantages. We developed a technique with the patient in the lateral position with a lateral needle trajectory to minimize the required needle depth from skin to target and a near-vertical needle trajectory. The aim of this study was to analyze the cohort for complications, procedural time, and effective radiation dose. MATERIALS AND METHODS: This was a retrospective evaluation of a single-center patient cohort. PACS images from the procedures were reviewed for needle depth, procedural time, and CTDI(vol). An anatomically relevant conversion factor was used to calculate the effective dose. RESULTS: One hundred sixteen cases from 110 patients were identified. The average patient age was 55 years. There were no complications. In 50% of cases, C5-6 was targeted. The average time was 6 minutes, and the average effective radiation dose, 0.51 mSv (0.21-2.56 mSv). Needle-insertion length from the skin to the target was highly correlated with a need for >3 needle repositioning adjustments and scan series (ρ = 0.52, P < .001) and increased procedural time (ρ = 0.42, P < .001). The angle of needle insertion relative to the floor was significantly correlated with an increased number of needle adjustments for depths >25 mm and a longer procedural time (ρ = 0.29, P = .01) but not for depths <25 mm. CONCLUSIONS: The lateral patient position with CT guidance is safe and allows use of a short needle in a vertical trajectory. This reduces the number of needle adjustments and imaging series to provide a short procedural time with a low effective radiation dose from the procedure.
Authors: Jenny K Hoang; Marc A Apostol; Peter G Kranz; Ramsey K Kilani; Jeffrey N Taylor; Linda Gray; Christopher D Lascola Journal: AJR Am J Roentgenol Date: 2010-10 Impact factor: 3.959
Authors: Cynthia H McCollough; Shuai Leng; Lifeng Yu; Dianna D Cody; John M Boone; Michael F McNitt-Gray Journal: Radiology Date: 2011-05 Impact factor: 11.105
Authors: K P Schellhas; S R Pollei; B A Johnson; M J Golden; J A Eklund; R S Pobiel Journal: AJNR Am J Neuroradiol Date: 2007-09-28 Impact factor: 3.825