Fluoroscopy-Guided S1 Transforaminal Epidural Injection: Simplified Technique for Better Demonstrating S1 Dorsal Foramina.

Abstract

Fluoroscopically guided S1 transforaminal epidural steroid injection (TFESI) is a treatment option for discogenic S1 radiculopathy or failed back surgery syndrome. Fluoroscopy plays an excellent role in treating S1 radiculopathy; however, it can sometimes be challenging due to complex sacral anatomy, bony flange, and bowel gas overlaps. In this technical report, we provide a simplified approach: fluoroscopic cranio-caudal angulation till we get an open fish-mouth appearance for better demonstration of the dorsal S1 neural foramina and ease of S1-TFESI.