LESI LESI Fluoroscopy and Imaging Guidance

Question 1

Fluoroscopic guidance for LESI is recommended over blind (landmark-based) injections primarily because:

Accepted Answer

It confirms accurate needle placement and reduces the rate of inaccurate injections from approximately 30-40% to near zero

Answer

It is faster than the blind technique

Answer

It eliminates all risk of complications

Answer

Insurance requires fluoroscopy for reimbursement only

Question 2

In fluoroscopic interlaminar LESI, the AP (anteroposterior) view is used primarily to:

Accepted Answer

Verify midline or paramedian needle position between the laminae

Answer

Confirm absence of intravascular injection

Answer

Assess disc morphology

Answer

Measure epidural space depth

Question 3

A 'Christmas tree' pattern of contrast spread on fluoroscopy during interlaminar LESI indicates:

Accepted Answer

Appropriate epidural spread along nerve roots

Answer

Intravascular injection

Answer

Intrathecal injection

Answer

Subdural injection

Question 4

Rapid disappearance of contrast on fluoroscopy during ESI, without epidural spread pattern, indicates:

Accepted Answer

Intravascular injection — injection should be stopped immediately

Answer

Correct epidural placement

Answer

Intrathecal injection

Answer

Air in the epidural space

Question 5

The lateral fluoroscopic view during interlaminar LESI is used primarily to confirm:

Accepted Answer

Needle depth (anterior-posterior positioning in the spinal canal)

Answer

Bilateral spread of contrast

Answer

Level identification

Answer

Absence of spondylolisthesis

Question 6

In transforaminal LESI under fluoroscopy, the oblique view is used to identify which landmark for needle placement?

Accepted Answer

The 'Scotty dog' silhouette to target the superior foramen (eye of the Scotty dog)

Answer

The disc space

Answer

The spinous process

Answer

The sacral hiatus