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- Jun 3, 2007
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Folks,
Background -
for pathology higher up in the cervical region, I have sometimes entered into the usually space (C7/T1) and threaded a catheter to get a more target specific injection. I use the regular epidural catheter we use in the OR - so soft tip, single orifice - non styleted catheter.
However, some of you have voiced concern over threading a catheter in this space.
Rather than me spend a bunch of time searching old threads trying to determine which thread this subject was addressed - can those of you who are against threading the catheter re-voice that opinion and reasons why? What are the known and described dangers and complications?
I am asking because I had never thought it was a concern previously until I read some of your thoughts and it has me concerned enough to rethink my practice. I was asked by the surgeon today to do a TFESI cervical for a patient who has C5 nerve root impingement. The surgon wants this done to PREVENT surgery, not for diagnostic purposes. The patient has had previous extensive neck surgery from an MVA years before so I can't do an ILESI - or don't want to. My options are 1) don't do it. 2)TFESI under CT with fluoro and DSA with non-particulate or just fluoro/DSA 3) ILESI at T2 or so - thread a catheter.
Background -
for pathology higher up in the cervical region, I have sometimes entered into the usually space (C7/T1) and threaded a catheter to get a more target specific injection. I use the regular epidural catheter we use in the OR - so soft tip, single orifice - non styleted catheter.
However, some of you have voiced concern over threading a catheter in this space.
Rather than me spend a bunch of time searching old threads trying to determine which thread this subject was addressed - can those of you who are against threading the catheter re-voice that opinion and reasons why? What are the known and described dangers and complications?
I am asking because I had never thought it was a concern previously until I read some of your thoughts and it has me concerned enough to rethink my practice. I was asked by the surgeon today to do a TFESI cervical for a patient who has C5 nerve root impingement. The surgon wants this done to PREVENT surgery, not for diagnostic purposes. The patient has had previous extensive neck surgery from an MVA years before so I can't do an ILESI - or don't want to. My options are 1) don't do it. 2)TFESI under CT with fluoro and DSA with non-particulate or just fluoro/DSA 3) ILESI at T2 or so - thread a catheter.