Dural puncture avoidance

[epidural man]

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L5-S1 IL is also the least likely potential for wet tap if you go paramedian. Nerve is the backstop, not the sac. Look at all that fat past the LF, doesn't matter if none dorsally midline.

Needle tip is right behind site of compression, do not need to worry about if flow is going up/down/medial enough, you are closer to target than any other injection and can use depo.
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I disagree with this.

You can’t tell by MRI where the medial edge of the lamina/inferior articulating process is so when doing not on fluoro - you really have no idea exactly where the needle is in relation to this picture.

 

[RoloTomassi]

I disagree with this.

You can’t tell by MRI where the medial edge of the lamina/inferior articulating process is so when doing not on fluoro - you really have no idea exactly where the needle is in relation to this picture.

L5-S1 usually has the widest window. You can see where the facet is. If you are just medial to facet you should be fine. Even more so if your needle is angling medial to lateral.