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Korean Journal of Anesthesiology 2005;49(4):542-544.
DOI: https://doi.org/10.4097/kjae.2005.49.4.542   
CT Guided Cervical Transforaminal Steroid Injection for the Elderly Patient with Enlarged Internal Jugular Vein and Vertebral Artery: A case report.
Hoondo Kim, Sang Ho Lee, Young Mi Han, Eui Woon Lee
1Department of Anesthesiology and Pain Medicine, Gimpo Airport Wooridul Spine Hospital, Seoul, Korea. hoondo_kim@hanmail.net
2Department of Neurosurgery, Gimpo Airport Wooridul Spine Hospital, Seoul, Korea.
Seventy nine-year old female patient visited our department presenting radicular pain on her neck, left shoulder and arm. She had a history of hypertension and underwent coronary angiography and angioplasty 4 years ago. Cervical MRI showed central disc herniation with osteophyte and left foraminal stenosis at C5-6 level and bulging disc with osteophyte and foraminal stenosis (left > right) at C6-7. First plan was transforaminal steroid injection under C-arm fluoroscopy at C5-6 level. Unexpectedly, we could find enlarged internal jugular vein and vertebral artery on MRI scan, which is due to cardiovascular disease. These important vascular structures were expected to be injured by needle during the procedure if done under C-arm fluoroscopy. We decided to give transforaminal steroid injection under CT fluoroscopy to avoid injury to the large vessels and inadvertent complication. The procedure was successfully done using CT fluoroscopy (Brilliance 10(TM), Philips(R), USA) without any complication associated with vascular injury or intravascular injection.
Key Words: computed tomography; spinal stenosis; transforaminal steroid injection


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