Reliability and Accuracy of MRI Laminar Angle Measurements to Determine Intra-Procedural Contralateral Oblique View Angle for Cervical or Thoracic Interlaminar Epidural Steroid Injections

Pain Medicine : the Official Journal of the American Academy of Pain Medicine
David S LeviAlexandra Collado

Abstract

Contralateral oblique (CLO) angle view has been a useful addition to standard views in fluoroscopically guided interlaminar epidural injections. Determination of the appropriate CLO angle is paramount in the usefulness of this technique. Using MRI laminar angle measurements as a pre-procedural guide for the intra-procedural fluoroscopic CLO angle has been proposed. The purpose of this study was to help determine if using axial MRI laminar measurements prior to a cervical or thoracic epidural steroid injection would be useful in predicting the appropriate fluoroscopic CLO angle. A retrospective review was performed for patients who underwent cervical or thoracic interlaminar injections. In the performance of interlaminar injections, the authors had routinely determined the true fluoroscopic contra-lateral oblique angle after epidural access was confirmed, for use during any potential future injections. The fluoroscopic CLO angle measurements were obtained from a chart review and compared blindly to each patient's MRI axial laminar angle measurements. 34 injections were included. Inter-rater reliability comparing the two authors' MRI angle measurements was considered fair, ICC = 0.395. Accuracy was only 57% comparing MRI laminar ...Continue Reading

References

Nov 26, 2003·Anesthesiology·Philipp LirkBernhard Moriggl
Feb 5, 2009·Journal of Spinal Disorders & Techniques·Andrew K SimpsonJonathan N Grauer
Nov 4, 2010·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Julien Vaisman
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Sep 16, 2014·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Jatinder S GillThomas T Simopoulos

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Citations

May 2, 2017·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·David Levi, Scott Horn

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