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Member
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Join Date: Jan 2009
Location: Paradise
Posts: 855
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Member
Join Date: Jan 2009
Location: Paradise
Posts: 855
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Quote:
Originally Posted by rlee
Actually, a TFESI should not be a "blind" procedure. If done correctly it should be done by a Physician who uses C-arm Radiology techniques, where the spine and foramen can be visualized throughout the procedure. If a Physician or clinic said they did not! perform these procedures in this manner, I would have it done elsewhere as a "Blind" Epidural injection of any sort, but especially foraminal would certainly have a high failure rate...So, PLEASE, ellow members, if considering this procedure, be sure to ask "HOW" they plan on performing.. Have a Great Day...Rita
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Correct...I don't think I know anyone in their right mind who doesn't use fluoro (c-arm) for transforaminals. While it is not entirely a blind procedure (the bones are well visualized), my reference to that is due to the soft tissues (muscles, nerves, blood vessels, etc.) being almost entirely not visualized with fluoro (it is an x-ray generator initially producing the beam and subject to the same non-visualization of soft tissues as conventional x-ray). Before my injuries, I was a primary provider with an x-ray and fluoroscopic supervisor permit in my state, owned a c-arm and so I know a thing or two about x-ray and fluoroscopic technique! There are adverse events in the literature regarding cervical transforaminals (12% from what I recall) where in worst case scenarios medications were injected into the vertebral artery or even events of puncturing the cord or exiting nerve root, causing a host of catastrophic events, including paralysis, stroke and death. I am not an alarmist, just a realist and fortunately these outcomes are uncommon! PM docs that I know are much more comfortable performing interlaminar ESI's in the cervical region.
Last edited by Dubious; 02-05-2014 at 01:18 AM.
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