When it comes to surgical and other interventional procedures “it is the decision, not the precision”. It does not matter how well you perform a procedure technically; it will not help if patient and procedure selection is incorrect. This is the case for CT-guided spinal interventions. Understanding the anatomy helps with correct planning.
However, under ideal circumstances the optimal procedure of choice should be:
- Lateral root canal stenosis - perineurial injection +/- direct spinal epidural.
- Intervertebral disc pathology - direct spinal epidural +/- bilateral.
- Facet joint related pathology, including where there is associated radiculopathy - facet joint procedure (usually facet joint injection in first instance).
- Central canal stenosis - direct spinal epidural (usually performed at the level above).