Can we Rotate the Head Safely During Cervical Nerve Root Injection?

Abstract

Objectives: Trans-foraminal epidural injections have been used successfully to aid in the management of cervicobrachialagia. The aim of this study was to assess the cross sectional area of the vertebral artery during transforaminal cervical nerve root injections (TFCNRI) when the head is typically rotated and to compare with the neutral position cross sectional area. We hypothesize that head rotation does not lead to a change of vertebral artery calibre at the neural foramen, thus this technique can be performed relatively safely during TFCNRI. Material and Methods: A pilot study involving a retrospective review of 16 computed tomography guided TFNRI was performed and cross sectional area of vertebral artery with head tilted and head in neutral position was performed. Results: There was no correlation between the degree of head rotation and change in the area of the ipsilateral or contralateral vertebral artery. Conclusion: We suggest that head can safely be rotated to varied degrees while performing TFCNRI.