{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T21:21:59Z","timestamp":1760217719386},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,8,27]],"date-time":"2015-08-27T00:00:00Z","timestamp":1440633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cervical epidural steroid injection (<jats:styled-content style=\"fixed-case\">CESI<\/jats:styled-content>), given in conjunction with local anesthetics, is a common remedy for cervical radicular pain and is generally performed under c\u2010arm fluoroscopic guidance, computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>), or ultrasound. Interlaminar procedures, such as <jats:styled-content style=\"fixed-case\">CESI<\/jats:styled-content>, typically rely on anteroposterior and lateral (<jats:styled-content style=\"fixed-case\">APL<\/jats:styled-content>) views during needle placement. However, lateral views may be obscured by body habitus in certain individuals. Swimmer's view or contralateral oblique (<jats:styled-content style=\"fixed-case\">CLO<\/jats:styled-content>) view may be used to avoid this.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Our intent was to assess technical success and procedural risk in patients subjected to image\u2010guided <jats:styled-content style=\"fixed-case\">CESI<\/jats:styled-content> procedures with <jats:styled-content style=\"fixed-case\">CLO<\/jats:styled-content> c\u2010arm fluoroscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 186 of patients were enrolled and randomly assigned to 1 of 3 groups undergoing image\u2010guided <jats:styled-content style=\"fixed-case\">CESI<\/jats:styled-content> via (1) <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>, (2) c\u2010arm fluoroscopy <jats:styled-content style=\"fixed-case\">CLO<\/jats:styled-content>, and (3) c\u2010arm fluoroscopy <jats:styled-content style=\"fixed-case\">APL<\/jats:styled-content>. Complication rates and technical success were assessed, basing the latter on image reviews to confirm the presence of epidural contrast.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All image\u2010guided <jats:styled-content style=\"fixed-case\">CESI<\/jats:styled-content> procedures utilizing <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CLO<\/jats:styled-content> fluoroscopy proved technically successful. In the <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> group, epidural needle tip and contrast dispersion were clearly visible at all levels of study. In the <jats:styled-content style=\"fixed-case\">CLO<\/jats:styled-content> subset, needle tip visibility was unclear in isolated instances at levels C6\u20107 and C7\u2010T1 (1 patient each level). In <jats:styled-content style=\"fixed-case\">APL<\/jats:styled-content> procedures, needle tip was regularly obscured by shoulder anatomy at levels C6\u20107 (26 of 41 patients) and C7\u2010T1 (15 of 16 patients), and contrast dispersion was often uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CLO<\/jats:styled-content> fluoroscopy\u2010guided <jats:styled-content style=\"fixed-case\">CESI<\/jats:styled-content> is feasible and safe, comparing favorably with <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\u2010guided <jats:styled-content style=\"fixed-case\">CESI<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12341","type":"journal-article","created":{"date-parts":[[2015,8,27]],"date-time":"2015-08-27T11:47:04Z","timestamp":1440676024000},"page":"814-819","source":"Crossref","is-referenced-by-count":3,"title":["Feasibility of Contralateral Oblique Fluoroscopy\u2010guided Cervical Interlaminar Steroid Injections"],"prefix":"10.1111","volume":"16","author":[{"given":"Chan Hong","family":"Park","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Dongrae Spine Health Wooridul Hospital Busan South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Spine Health Wooridul Hospital Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,27]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-006-0258-2"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31823b4d1f"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.4444"},{"key":"e_1_2_5_5_1","doi-asserted-by":"crossref","first-page":"223","DOI":"10.36076\/ppj.2010\/13\/223","article-title":"The effectiveness of fluoroscopic cervical interlaminar epidural injections in managing chronic cervical disc herniation and radiculitis: preliminary results of a randomized, double\u2010blind, controlled trial","volume":"13","author":"Manchikanti L","year":"2010","journal-title":"Pain Physician"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S32692"},{"key":"e_1_2_5_7_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.36076\/ppj.2012\/15\/13","article-title":"Fluoroscopic cervical interlaminar epidural injections in managing chronic pain of cervical postsurgery syndrome: preliminary results of a randomized, double\u2010blind, active control trial","volume":"15","author":"Manchikanti L","year":"2012","journal-title":"Pain Physician"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199810010-00020"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200203010-00011"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0303100512"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.3344\/kjp.2010.23.4.254"},{"key":"e_1_2_5_12_1","doi-asserted-by":"crossref","first-page":"E405","DOI":"10.36076\/ppj.2012\/15\/E405","article-title":"Effectiveness of cervical epidural injections in the management of chronic neck and upper extremity pain","volume":"15","author":"Diwan S","year":"2012","journal-title":"Pain Physician"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.6809"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2010.00829.x"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2012.01484.x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2011.01291.x"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12557"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2954"},{"key":"e_1_2_5_19_1","first-page":"395","article-title":"Epidural anatomy examined by cryomicrotome section. 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