11 doctors weighed in:

Is it safe to have a steroid epidural injection without the use of X-ray for guidance?

11 doctors weighed in
Dr. Qamar Khan
Pain Management
3 doctors agree

In brief: Generally No

It is not standard of care at all.
Used to be when we didn't have x-ray, but not anymore. In fact the CPT codes used to bill these types of injections now have fluoroscopic guidance built into them, including the older technique done bedside which will change for 2015. So never get an epidural without x-ray unless your are having a baby or for surgery.

In brief: Generally No

It is not standard of care at all.
Used to be when we didn't have x-ray, but not anymore. In fact the CPT codes used to bill these types of injections now have fluoroscopic guidance built into them, including the older technique done bedside which will change for 2015. So never get an epidural without x-ray unless your are having a baby or for surgery.
Dr. Qamar Khan
Dr. Qamar Khan
Thank
Dr. Jeffrey Glaser
Pain Management
3 doctors agree

In brief: Possibly

Women in labor receive labor epidurals all the time without fluoroscopy/x-ray guidance and this is considered a normal standard of care.
When doing epidural steroid injections for treatment of pain there are many reasons why x-ray guidance has become the standard of care and not using x-ray guidance is considered below the standard of care in many communities. X-ray guidance improves safety.

In brief: Possibly

Women in labor receive labor epidurals all the time without fluoroscopy/x-ray guidance and this is considered a normal standard of care.
When doing epidural steroid injections for treatment of pain there are many reasons why x-ray guidance has become the standard of care and not using x-ray guidance is considered below the standard of care in many communities. X-ray guidance improves safety.
Dr. Jeffrey Glaser
Dr. Jeffrey Glaser
Thank
1 comment
Dr. Thomas Namey
I was taught by a 71 year old anesthesiologist in the 80s. He never used it. Nor have I!
2 doctors agree

In brief: Depends

Most of the time ( current stranded all of the time ) faucet nerve root steroid injections are done for accuracy and safety using x-ray guidance, but trigger point injections are done with out c-arm ( x-ray) guidance.

In brief: Depends

Most of the time ( current stranded all of the time ) faucet nerve root steroid injections are done for accuracy and safety using x-ray guidance, but trigger point injections are done with out c-arm ( x-ray) guidance.
Dr. Addagada Rao
Dr. Addagada Rao
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Dr. William Jenkins
Anesthesiology
1 doctor agrees

In brief: Yes,

Unless transforaminal.
Experienced anesthesiologists can easily find the epidural space without the expense and radiation exposure of continuous xray. It is commonly done.

In brief: Yes,

Unless transforaminal.
Experienced anesthesiologists can easily find the epidural space without the expense and radiation exposure of continuous xray. It is commonly done.
Dr. William Jenkins
Dr. William Jenkins
Thank
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