{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T02:33:59Z","timestamp":1778898839115,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2018,3,9]],"date-time":"2018-03-09T00:00:00Z","timestamp":1520553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Compared with other available injection techniques for lumbar transforaminal epidural steroid injections (LTFESIs), the traditionally performed subpedicular approach is associated with a higher risk of spinal cord infarction, a rare but catastrophic complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the short-term efficacy of the retroneural approach for computed tomography (CT)-guided LTFESIs with respect to different needle-tip positions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>This retrospective analysis included 238 patients receiving 286 CT-guided LTFESIs from January 2013 to January 2016. Short-term outcomes in terms of pain relief were assessed using the visual analogue scale (VAS) at baseline and 30\u2009min after. The needle-tip location was categorized as extraforaminal, junctional, or foraminal relative to the neural foramen. Additionally, the distance from the needle tip to the nerve root was measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A mean pain reduction of 3.22 points (\u00b12.17 points) on the VAS was achieved. The needle-tip location was extraforaminal in 48% (136\/286), junctional in 42% (120\/286), and foraminal in 10% (28\/286) of the cases. The mean distance from the needle tip to the nerve root was 3.83\u2009mm (\u00b13.37\u2009mm). There was no significant correlation between pain relief and needle-tip position in relation to the neural foramen. Therapy success was not dependent on the distance between the needle tip and the nerve root. No major complications were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In our population treated with LTFESIs, the retroneural approach was shown to be an effective technique, with no significant differences in pain relief following different needle-tip positions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0284185118762248","type":"journal-article","created":{"date-parts":[[2018,3,9]],"date-time":"2018-03-09T23:16:05Z","timestamp":1520637365000},"page":"1508-1516","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["The retroneural approach: an alternative technique for lumbar transforaminal epidural steroid injections"],"prefix":"10.1177","volume":"59","author":[{"given":"Stefan","family":"Ignjatovic","sequence":"first","affiliation":[{"name":"Institute of Radiology, Kantonsspital Baden AG, Baden, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reza","family":"Omidi","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Kantonsspital Baden AG, Baden, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahel A","family":"Kubik-Huch","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Kantonsspital Baden AG, Baden, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Anderson","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Kantonsspital Baden AG, Baden, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank J","family":"Ahlhelm","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Kantonsspital Baden AG, Baden, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,3,9]]},"reference":[{"key":"bibr1-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1517\/14656560903304063"},{"key":"bibr2-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2016.06.008"},{"key":"bibr3-0284185118762248","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.8105.2"},{"key":"bibr4-0284185118762248","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2012\/15\/E199"},{"key":"bibr5-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2012.01508.x"},{"key":"bibr6-0284185118762248","doi-asserted-by":"crossref","first-page":"163","DOI":"10.36076\/ppj.2009\/12\/163","volume":"12","author":"Parr AT","year":"2009","journal-title":"Pain Physician"},{"key":"bibr7-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e31828ea086"},{"key":"bibr8-0284185118762248","first-page":"A23","volume":"121","author":"Wanderer JP","year":"2014","journal-title":"Anesthesiology"},{"key":"bibr9-0284185118762248","doi-asserted-by":"crossref","unstructured":"Manchikanti L, Pampati V, Hirsch JA. Retrospective cohort study of usage patterns of epidural injections for spinal pain in the US fee-for-service Medicare population from 2000 to 2014. BMJ Open 2016;6:e013042.","DOI":"10.1136\/bmjopen-2016-013042"},{"key":"bibr10-0284185118762248","first-page":"7","volume":"10","author":"Boswell MV","year":"2007","journal-title":"Pain Physician"},{"key":"bibr11-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e3283628e87"},{"key":"bibr12-0284185118762248","doi-asserted-by":"crossref","first-page":"321","DOI":"10.36076\/ppj.2013\/16\/321","volume":"16","author":"Atluri S","year":"2013","journal-title":"Pain Physician"},{"key":"bibr13-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-008-9035-2"},{"key":"bibr14-0284185118762248","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2011.35.6.833"},{"key":"bibr15-0284185118762248","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2016.09.04"},{"key":"bibr16-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2213001635"},{"key":"bibr17-0284185118762248","unstructured":"R Core Team. R: A language and environment for statistical computing. 3.1.1. Vienna: R Foundation for Statistical Computing, 2014. Available at: http:\/\/www.R-project.org\/."},{"key":"bibr18-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2007.09.005"},{"key":"bibr19-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2010.00948.x"},{"key":"bibr20-0284185118762248","doi-asserted-by":"crossref","first-page":"327","DOI":"10.36076\/ppj\/2016.19.327","volume":"19","author":"Makkar JK","year":"2016","journal-title":"Pain Physician"},{"key":"bibr21-0284185118762248","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1998.89.5.0791"},{"key":"bibr22-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-009-1539-7"},{"key":"bibr23-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000614"},{"key":"bibr24-0284185118762248","doi-asserted-by":"crossref","unstructured":"Gangi A, Guth S, Dietemann JL, et\u00a0al. Interventional musculoskeletal procedures. Radiographics 2001;21:E1.","DOI":"10.1148\/radiographics.21.2.g01mre1e1"},{"key":"bibr25-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2010.07.003"},{"key":"bibr26-0284185118762248","first-page":"515","volume":"15","author":"Chang Chien GC","year":"2012","journal-title":"Pain Physician"},{"key":"bibr27-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-2007-z"},{"key":"bibr28-0284185118762248","first-page":"46","volume":"17","author":"Simon JI","year":"2016","journal-title":"Pain Med"},{"key":"bibr29-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnv067"},{"key":"bibr30-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2011.01119.x"},{"key":"bibr31-0284185118762248","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2011.35.3.395"},{"key":"bibr32-0284185118762248","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2016.09.016"}],"container-title":["Acta Radiologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0284185118762248","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0284185118762248","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0284185118762248","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:21:46Z","timestamp":1777389706000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0284185118762248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,9]]},"references-count":32,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1177\/0284185118762248"],"URL":"https:\/\/doi.org\/10.1177\/0284185118762248","relation":{},"ISSN":["0284-1851","1600-0455"],"issn-type":[{"value":"0284-1851","type":"print"},{"value":"1600-0455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,9]]}}}