September-October 2017

Introduction

Image-Guided Spine Pain Management

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Vinil Shah

It is my pleasure to serve as the guest editor of this edition of the AJNR News Digest, which focuses on the topic of image-guided spine pain management. Disorders of the spine have a tremendous impact on society—directly through the morbidity of afflicted individuals and indirectly through lost productivity and increased health … more »

Spine

Intraforaminal Location of Thoracolumbar Radicular Arteries Providing an Anterior Radiculomedullary Artery Using Flat Panel Catheter Angiotomography

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Lydia Gregg

We chose this research topic after noting that previous studies of the intraforaminal location of radicular arteries providing an anterior radiculomedullary artery (ARMA) were limited by 1) the field of view investigated, 2) the use of the cadaveric materials, or 3) the inability to specify whether the studied vessels were radicular branches … more »

Spine

CT Fluoroscopic Cervical Transforaminal Epidural Steroid Injections: Extraforaminal Needle Tip Position Decreases Risk of Intravascular Injection

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Gerritt Lagemann

Transforaminal epidural steroid injections (TFESIs) are commonly performed in the evaluation and treatment of radicular neuropathy. Although TFESIs are widely performed in the lumbar spine, many proceduralists are reluctant to perform cervical TFESIs due to the risk of rare but serious complications such as posterior circulation stroke and spinal cord infarct. These … more »

Spine

Deleterious Effects of Intra-arterial Administration of Particulate Steroids on Microvascular Perfusion in a Mouse Model

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Jean-Denis Laredo

Ninety severe and sometimes fatal neurologic events occurring immediately after epidural injection of suspensions of particular glucocorticoids were reported to the FDA between 1997 and 2014, most being foraminal injections.1 Our team reported 5 cases of paraplegia complicating selective injections of particulate steroids in the lumbar spine.2

The almost immediate onset of neurologic … more »

Spine

Inadvertent Intrafacet Injection during Lumbar Interlaminar Epidural Steroid Injection: A Comparison of CT Fluoroscopic and Conventional Fluoroscopic Guidance

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Peter Kranz

CT fluoroscopy (CTF) is a powerful technology for performing image-guided procedures. It marries the benefits of cross-sectional imaging with real-time intraprocedural imaging to allow for highly precise image guidance. Procedures can usually be performed as quickly as conventional fluoroscopy-guided procedures and with equivalent or decreased radiation doses. CTF particularly excels in cases … more »

Spine

Percutaneous Injection of Radiopaque Gelified Ethanol for the Treatment of Lumbar and Cervical Intervertebral Disc Herniations: Experience and Clinical Outcome in 80 Patients

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Matteo Bellini

Sciatica due to a lumbar disc herniation and nerve root irritation is a huge public health problem not yet benefiting from an unequivocal treatment approach. Even cervical hernias with brachialgia afflict a substantial range of the population.

Medical and physical therapies represent the first therapeutic steps. When these fail, minimally invasive treatments may … more »