Choi Jongwoo, Kim Nackhwan, Smuck Matthew, Lee Sang-Heon
Graduate School, College of Medicine, Korea University, Seoul, Republic of Korea.
Spine Center, Korea University Anam Hospital, Seoul, Republic of Korea.
Pain Res Manag. 2019 Mar 3;2019:2651504. doi: 10.1155/2019/2651504. eCollection 2019.
There is no report on the effect of injectate viscosity on epidural distribution for lumbar transforaminal epidural steroid injections (L-TFESIs). The aim of this study was to evaluate the influence of injectate viscosity on the volume needed to reach specific landmarks in L-TFESIs.
A prospective, randomized, comparative human study involving 118 patients undergoing L-TFESIs was conducted. The study subjects were divided into two groups by a random selection method: raw viscosity group (RV, =58) and low viscosity group (LV, =60). Contrast volumes were recorded as the contrast flow reached specific anatomical landmarks under fluoroscopic guidance.
The possibility of delivering the injectate to each landmark showed a positive correlation with the amount and a negative correlation with the viscosity of the injectate. However, for landmarks at the medial aspect of the superior pedicle of the corresponding level of injection and for those beyond the spinous process over the contralateral spinal segment, the influence of viscosity was not statistically significant.
The epidural distribution of the contrast agent through the transforaminal approach was most affected by the injectate volume and was also partly affected by the viscosity.
关于注射剂粘度对腰椎经椎间孔硬膜外类固醇注射（L-TFESI）硬膜外分布的影响尚无报道。本研究的目的是评估注射剂粘度对L-TFESI中到达特定标志所需体积的影响。
进行了一项前瞻性、随机、对比性人体研究，纳入118例行L-TFESI的患者。通过随机选择方法将研究对象分为两组：原液粘度组（RV，n = 58）和低粘度组（LV，n = 60）。在透视引导下，当造影剂流至特定解剖标志时记录造影剂体积。
将注射剂输送至每个标志的可能性与注射剂的量呈正相关，与注射剂的粘度呈负相关。然而，对于注射相应节段上椎弓根内侧的标志以及对侧脊柱节段棘突上方的标志，粘度的影响无统计学意义。
经椎间孔途径造影剂的硬膜外分布受注射剂体积影响最大，也部分受粘度影响。
