Navigating and Troubleshooting Lumbosacral Fluoroscopic Procedures-Navigating and Troubleshooting Lumbosacral Fluoroscopic Procedures

Video Transcription

Video Summary

In this video, the speaker discusses lumbar epidural injections for treating lumbar radicular pain, lumbar stenosis, and other conditions. They explain the different approaches, including interlaminar and transforaminal injections, and discuss indications and goals of the procedure. The speaker also talks about diagnostic value, efficacy, and safety considerations, as well as anatomical landmarks and imaging techniques used to guide the injections. Case examples are provided to illustrate concepts.<br /><br />The video also addresses concerns related to the use of epidural steroid injections, particularly the use of particulate steroids which have a higher risk of complications. New CMS guidelines restricting repeat injections within three months also raise concerns without clear evidence to support them. The efficacy of interlaminar and transforaminal approaches are discussed, with some studies suggesting that transforaminal injections provide earlier relief but may be more painful. The choice of approach depends on the patient's condition and other factors.<br /><br />Transitional anatomy and the use of oblique views for guidance are mentioned, as well as the use of epidural injections for lumbar facet synovial cysts which have a success rate of about one-third for aspiration or rupture.<br /><br />Overall, the video provides a comprehensive overview of lumbar epidural injections, discussing various aspects from techniques and imaging to efficacy and potential complications.

Keywords

lumbar epidural injections

lumbar radicular pain

lumbar stenosis

interlaminar injections

transforaminal injections

diagnostic value

efficacy

complications

CMS guidelines

transitional anatomy

lumbar facet synovial cysts