Aim of Investigation: The aim of this study is to determine whether an oblique radiograph can visualize inappropriate spread of solution in the performance of thoracic sympathetic block (TSB).
Methods: Forty-two TSBs at 83 vertebral levels were included in this study. TSB was performed with patients prone on the fluoroscopic table. Three directional radiographs which consisted of P-A, lateral and oblique views were taken after placement of needles and administration of contrast solution. For an oblique radiograph, direction of X-ray was angled at 15-20 degrees from the saggital plane to the affected side.
Results: In the oblique radiograph, untoward spread of the contrast solution into the intervertebral foramen and the epidural space could be clearly identified without any overlap of the contrast mass located against the anterolateral aspect of the vertebral body. Such inappropriate flow was seen at 16 vertebral levels (19%), out of which, at 10 levels (63%), it could be identified only in the oblique view.
Conclusion: The oblique contrast radiograph could visualize inappropriate epidural flow of the injected solution and was helpful to prevent complications of TSB.