On the geometry of fluoroscopy views for cervical interlaminar epidural injections

Pain Med. 2012 Jan;13(1):58-65. doi: 10.1111/j.1526-4637.2011.01291.x. Epub 2011 Dec 5.


Objectives: To describe how the anatomy of the cervicothoracic vertebrae predicates the appropriate fluoroscopic views for confirming safe needle placement during the performance of interlaminar cervical epidural injections.

Methods and results: Illustrations, cadaver models, and radiographic images were correlated and used to illustrate and derive a mathematical model to demonstrate the utility of a contralateral oblique fluoroscopic view during the performance of cervical interlaminar injections.

Conclusions: When confirming needle placement during a cervical interlaminar epidural injection, in addition to the anterior-posterior fluoroscopic view, the oblique image, contralateral to the needle tip position, may provide superior information to that afforded by a lateral view.

MeSH terms

  • Analgesia, Epidural / instrumentation*
  • Analgesia, Epidural / methods*
  • Cervical Vertebrae / anatomy & histology
  • Cervical Vertebrae / diagnostic imaging*
  • Cervical Vertebrae / drug effects
  • Contrast Media / administration & dosage
  • Epidural Space / diagnostic imaging
  • Epidural Space / drug effects
  • Fluoroscopy / instrumentation
  • Fluoroscopy / methods
  • Humans
  • Injections, Epidural
  • Models, Theoretical
  • Prospective Studies


  • Contrast Media