US Cervical Interlaminar ESI ?

[Aether2000]

Other than AAPMU anyone teaching these? Anyone doing these?

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[oreosandsake]

a group in Ohio was doing cervical SNRB under US for a year

then they didn't get paid for a single one of them. switched back to C ILESI w/ fluoro

 

[Taus]

Interlam w US is akin to blind or no lateral (or CLO).... No?

 

[ampaphb]

US, IMHO, was an ecconomic driver. When you got paid more for the modality, some felt it was worth learning how to use the technology. Now that reimbursement sources have recognized that it is being used for guidance, and not diagnostic purposes, and reduced payment accordingly, there is little/no reason to pursue it.

 

[Aether2000]

I became aware of one person doing these and they believe it is safer than fluoroscopy guided Interlaminar cervical esi. I had never heard of it. They along claimed the AAPMU is teaching this technique......

 

[nvrsumr]

I think with the 2015 CMS fee schedule combining flouro with CESI this is a nonissue.

Pretty dumb idea unless comparing to blind.

 

[drf]

I became aware of one person doing these and they believe it is safer than fluoroscopy guided Interlaminar cervical esi. I had never heard of it. They along claimed the AAPMU is teaching this technique......

AAPMU teaches the US anatomy and US assisted techniques to help place the needle. This is more helpful for regional anesthesia applications that are otherwise blind.

The use of US for epidural injections in chronic pain is extremely limited. No one would ever inject without fluoro confirmation and contrast.

 

[DOctorJay]

AAPMU teaches the US anatomy and US assisted techniques to help place the needle. This is more helpful for regional anesthesia applications that are otherwise blind.

The use of US for epidural injections in chronic pain is extremely limited. No one would ever inject without fluoro confirmation and contrast.

don't be so sure, I've seen it reported for a LESI, no mention of fluoro confirmation

 

[bedrock]

still crazy to use anything but fluoro for cervical ILESI

 

[drf]

don't be so sure, I've seen it reported for a LESI, no mention of fluoro confirmation

Only if the other option is blind.

All I'm saying is no one in AAPMU is advocating for US guided cervical epidural steroid injections. It's simply not true.