Devoted to diagnostic and interventional spine imaging and therapeutics


Transforaminal epidural steroid injection for low back pain: Comparison of fluoroscopy time and radiation dose at different levels of lumbosacral nerve 2012

Interventional Spine

Jina, Kim, M.D.
Min Hee, Lee, M.D., Non ASSR Member
Myung Jin, Shin, M.D., Non ASSR Member
Yun Mi, Hwang, M.D., Non ASSR Member
Sang Hoon, Lee, M.D., Non ASSR Member
Hye Won, Chung, M.D., Non ASSR Member



Among techniques of lumbosacral epidural steroid injection (ESI), transforaminal (TF) approach is considered to be more specific to the site of pathology. We compared fluoroscopy time and radiation dose at different levels of the lumbosacral nerve during TF ESI.

Methods & Materials

Tranforaminal ESI for managing sciatica was performed in 181 patients (68 males, 113 females; mean age, 61.3 years) for 6-month period. All patients were categorized into three groups according to the injected levels of lumbosacral nerves; L2-4 in 29, L5 in 123 and S1 in 29. All ESIs were conducted under a single plane fluoroscopic guidance by three musculoskeletal radiologists with 6~16-year-experience. Fluoroscopic settings were 16 ms of pulse width, 15 p/s of pulse rate at 70 kv. Fluoroscopy time (FT) and dose-area product (DAP) were recorded in all patients. FT and DAP were correlated at each group and compared in three different groups. Statistical analysis was performed using Pearson correlation and linear regression correlation (Stata version 11; Stata Corp LP, College Station, TX, USA). Statistical significance was set at P <0.05.


FT ranged from 14 to 113 sec at L2-4, from 11 to 161 sec at L5, and 18-138 sec at S1. DAP ranged from 37.4 to 529.6 μGyâ