Contralateral oblique view can prevent dural puncture in fluoroscopy-guided cervical epidural access: a prospective observational study
Authors' conclusion
The fluoroscopy-guided CLO view at 50°±5° avoided dural puncture or spinal cord injury and decreased the incidence of false LOR during cervical epidural access with a paramedian approach.
Study context
- Population
- Patients undergoing fluoroscopically guided cervical interlaminar epidural accessincluded for analysis
- Participants
- 393 patients
- Outcome
- Incidence of dural puncture
Main finding
As reported in the abstract
Dural puncture
- No instances of dural puncture observed
Observational data: associations, not effects.
Secondary outcomes
Procedural success
- First-pass success rate
- 85.0%
- All procedures successfully performed
Needling time
- Mean needling time (SD), s
- 133.8 (74.9)
False loss of resistance (LOR)
- False-positive LOR rate
- 8.2%
- False-negative LOR rate
- 2.0%
Needle tip visualisation
- All needle tips visualized clearly during the procedure
Safety
Spinal cord injury
- No instances of spinal cord injury observed
Intravascular, vasovagal reaction and subdural entry incidence
- Intravascular entry
- 3.1%
- Vasovagal reaction
- 0.5%
- Subdural entry
- 0.3%
Original publication
Contralateral oblique view can prevent dural puncture in fluoroscopy-guided cervical epidural access: a prospective observational study. Reg Anesth Pain Med. Published 6 April 2023. doi:10.
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