Informed consent obtained and risks and benefits were explained. The patient was placed prone on fluoroscopy table. The skin from L2 to S2 was prepped with povidone‑iodine and draped in sterile manner. Aseptic technique was used at every stage of the procedure. Heart rate, blood pressure, respiratory rate, and oxygen saturation were monitored throughout the procedure.
Fluoroscopy was used and left S1 foramen was identified. The skin overlying the area was infiltrated and anesthetized with 2.5 mL of 1% preservative free lidocaine. A 22‑gauge 3Â½-inch spinal needle was inserted and initially guided under an AP view. Under AP visualization, the needle was advanced until it was felt to go firmly into the S1 foramen. The C‑arm was then slightly rotated toward the lateral view to confirm the needle position. A 1 mL of Omnipaque dye was injected to allow visualization of flow into the posterior epidural space and along the nerve root. There was no evidence of vascular flow. The aspiration was performed without evidence of blood or CSF.
A 3 mL mixture of 2 mL of triamcinolone (40 mg/mL) with 1 mL 1% preservative-free lidocaine were injected at the S1 level. A total of one spinal needle was used for this procedure. Intravenous conscious sedation was not used
AP fluoroscopic view is reviewed.This demonstrates a spinal needle at the L5-S1 intralaminar space. There appears to be flow into the epidural space. No evidence of vascular flow or flow into adjacent compartments.
The patient was transported to recovery. Vital signs were stable and the injection sites were cleaned. The patient was discharged to home in care of his wife. He was told to come with any concerns or questions otherwise see me in two weeks for follow up.
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join