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Cervical interlaminar injection: C arm,lecture & clinical case 

Practical Pain Management with Dr. Lee
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A brief review of the C arm anatomy of the cervical spine
AP and oblique c-arm approach technique, not the lateral view guidance interventional procedure
I explained the C-arm anatomy of the cervical spine. I choose AP and oblique C arm guidance interventional procedure rather than the oblique and lateral approach. It took more time and radiation hazard to undergo the lateral C arm guided procedure. In this tutorial, you will learn the basic step of an interventional procedure and how to handle the C arm image.
you will learn MRI features of patients who need a c arm guided interlaminar l steroid injection.
this course is an Image training channel. you would recognize in the feature that you advanced much by just repeating playback.
repeated watching will give you more opportunity to understand and you doing practice by yourself.
It is the goal of the image training session.
#imagetraining #lumbar #backpain #interventionaltreatment #Ziemvision #Carm #chronicpain #transforaminal #facetjoint #cervicalspine #cervicainterlaminar
#신경차단술 #이미지트레이닝 #요추후관절통증 #요추신경통 #요추신경근통 #투시 #요통 #통증중재시술 #만성통증

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22 ноя 2020

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Комментарии : 62   
@oosmaaaru2073
@oosmaaaru2073 3 года назад
감사합니다
@user-ht3ug8xv6d
@user-ht3ug8xv6d 2 года назад
좋은 영상 감사합니다
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
저도 감사합니다
@orthospinechannel9450
@orthospinechannel9450 2 года назад
Good educational video.
@practicalpainmanagementwit8115
thank you
@PainMedir
@PainMedir Год назад
Awesome technique
@practicalpainmanagementwit8115
Thank you! Cheers!
@aneskim
@aneskim Год назад
선생님 감사합니다. 전문의 딴지 2년차된 꼬꼬마입니다. 덕분에 많은 도움 되고 있습니다.
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 11 месяцев назад
도움이 되셨다니 감사합니다
@aparnagotur
@aparnagotur Год назад
very well demonstrated .
@practicalpainmanagementwit8115
thank you
@caiyu538
@caiyu538 9 месяцев назад
Great
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 9 месяцев назад
thank you
@user-bc1md5qc2u
@user-bc1md5qc2u Год назад
선생님, 매우 인상 깊게 보았고 저도 현재 이 방법을 따라하고 있습니다. 궁금한 게 있습니다. 혹시, CLO view 맞출 때 C-arm을 몇 도 정도 맞추고 계신가요? 저는 대략 45도 정도 맞추고 하고 있습니다. 좋은 컨텐츠 감사합니다.
@practicalpainmanagementwit8115
많은 동영상에 올려 드렸습니다. 확인 부탁드립니다
@drsgb
@drsgb 2 года назад
Dr. Lee. Do you use a 20 gauge or 18 gauge Tuohy needle for your cervical and lumbar interlaminar injections? Thank you.
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
I use 22G 8cm needle for the cervical and lumbar injection.
@sabiston002
@sabiston002 3 года назад
Nice job! Dr. Lee! It is a very educational video. What kind of do you use in cervical epidural steroid injection? It looks like triamcinolone. Is it right?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 года назад
Thank you for your comment. In the cervical area, triamcinolone is forbidden because is a particulate steroid. I always use dexamethasone palmitate, the brand name is "Limethason"
@bizkits2517
@bizkits2517 3 года назад
But the fluid is so white. Looks like Triamcinolone to me.
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 года назад
@@bizkits2517 dexamethasone palmitate is white color, looks like triam, but is is not. particular steroid is forbidden in cervical spine
@kimdamrong8350
@kimdamrong8350 3 года назад
@@practicalpainmanagementwit8115 so it mean Limethason is only best choice for cervical spine. I think Triamcinolone is a particle so it is dangerous to use in cervical spine.
@Tobias27_
@Tobias27_ Год назад
Thx for this lecture. Why don't you use the loss of resistance technique to be sure not to puncture to the dural layer? I have got so much experience with interlaminer epidural injection by loss of resistance method but I don't have confidence to me for your technique. Maybe I will try it when I get more adept on interventional procedure.
@practicalpainmanagementwit8115
The loss of resistance technique and the use of contrast media infiltration both serve the same purpose, which is to help identify the correct space during a medical procedure. The loss of resistance technique involves the use of a fluid, such as saline, that is used to help identify a specific space, while the use of contrast media infiltration involves the injection of a radiopaque contrast material to visualize the space under imaging. Both methods are used to confirm the correct placement of a needle, catheter, or other instrument during a procedure. The loss of resistance technique is considered less definitive than contrast media infiltration, as the presence of contrast material provides a clear and unmistakable visualization of the targeted space. Overall, both methods have their advantages and disadvantages, and the choice of technique may depend on the specific procedure, the experience and preference of the practitioner, and other factors.
@drsgb
@drsgb 2 года назад
At 4:31 it states "ipsilateral oblique rotation" for the C-arm. Did you mean contralateral oblique?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
Yes, It is contralateral oblique rotation. thank you for your comment
@flavioaleixo8627
@flavioaleixo8627 2 года назад
Excelent
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
thank you
@orthospinechannel9450
@orthospinechannel9450 2 года назад
Can you do an educational video for transforaminal cervical root block.
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
I do not perform C arm guided transforaminal anymore. I do ultrasound guided and parasagittal epidural with ipsilateral facet joint injection.
@enriquevillalobos1773
@enriquevillalobos1773 Год назад
@@practicalpainmanagementwit8115 wow
@user-xy5wh7bm7t
@user-xy5wh7bm7t Год назад
Great dr. Lee. How much drugs and what drugs did you do. And in what level you did block, is it VC7-VTH1. Is it amount of drug depend from how much level you want to cover. And what about technique of loss resistance dod yoo use. Thank you.
@practicalpainmanagementwit8115
I use 2ml of dexamethasone palmitate in total. it will be 5mg of dexamethasone equivalent. I mixed it with 1ml of local anesthetics. so, 3ml of fluid covers the whole cervical spine if the fluid flow to the wanted direction by parasagittal approach.
@rafaelmoralesvalero4358
@rafaelmoralesvalero4358 Год назад
I think dr Lee dondt use loss resistence, he does it just with Carm Anatomy, is it true?
@jimmyDhamma
@jimmyDhamma Год назад
Can we use dexamethasone sodium phosphate in this case doctor lee?
@simo-dv5xk
@simo-dv5xk 4 месяца назад
Hi Dr, is PRP cervical epidural high risk when there is already severe central/foraminal stenosis with cord compression? Can injecting PRP when there is already minimal space cause even further cord compression and possible hemetoma? Thanks.
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 месяца назад
PRP is not a miraculous solution; be cautious of placing undue trust in such idealistic views.
@simo-dv5xk
@simo-dv5xk 3 месяца назад
@@practicalpainmanagementwit8115 In which specific cases do you recommend PRP?
@eduardosolano1202
@eduardosolano1202 3 месяца назад
Cuantas veces y cada cuanto tiempo es posible poner la inyeccion
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 25 дней назад
On average 3 times. Each 2 ample of dexamethasone palmitate
@KA-gg6go
@KA-gg6go 3 года назад
Will you be able to see if hyoid bone is fractured?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 года назад
I don't have any experience to hyoid bone fracture.
@orthospinechannel9450
@orthospinechannel9450 2 года назад
If Iam not wrong your needle was on right side and c-arm recorder was tilted to the left and the vice versa if the needle is on the left side..Am I right. kindly clarify..
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
yes you are right
@user-jj9vc7pk1b
@user-jj9vc7pk1b 10 месяцев назад
Epidural block의 경우 ap lat을 저장해야하지 않나요
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 10 месяцев назад
epidural block은 아직 특별한 규정이 없는 것으로 알고 있어요
@enriquevillalobos1773
@enriquevillalobos1773 Год назад
You mean contralateral oblique? Also question usually how many degrees do you find your optimal view?
@practicalpainmanagementwit8115
There are numerous lecture videos available demonstrating the degree of C-arm angulation. I recommend finding and watching them to gain a better understanding
@drsgb
@drsgb Год назад
50 degrees is optimal according to this study. pubmed.ncbi.nlm.nih.gov/28072809/
@orthospinechannel9450
@orthospinechannel9450 2 года назад
How do you position the patient. I find it difficult to do this injection with patient in prone position.. Any tips in positioning of patient will be acknowledged.
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
prone position as we watch at the video. maybe you ask your technician to align well the cervical disc plane on AP and turn obliquely to well visualize the tangential angle to the lamina.
@orthospinechannel9450
@orthospinechannel9450 2 года назад
Contralateral oblique c-arm view. Why the word rotation added.. does the c-arm needed to be rotated too. Kindly clarify..
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
patient is in prone, the C arm rotate to contralateral oblique
@jimmyDhamma
@jimmyDhamma Год назад
Can we use dexamethasone sodium phospate in this case doctor lee?
@practicalpainmanagementwit8115
No, dexamethasone palmitate. You have to increase dosage when you use dexamethasone sodium phosphate.
@jimmyDhamma
@jimmyDhamma Год назад
Because we dont have it in indonesia dr, do u hv any suggestion?and what is the equal dose for dexamethasom sodium phospate?
@user-xk7cq3zt6x
@user-xk7cq3zt6x 7 месяцев назад
선생님 영상 잘 보았습니다 병원 알려주실 수 있나요?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 7 месяцев назад
전라북도 전주에 있습니다
@Jalmanza89
@Jalmanza89 2 года назад
Why is the II so high. That’s more dose to the patient
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
what does mean of II ?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
Do you mean radiation dose?
@user-jj9vc7pk1b
@user-jj9vc7pk1b 10 месяцев назад
​@@practicalpainmanagementwit8115ii는 영상증배관의 줄임말입니다. 디텍터쪽에 있습니다
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