Neurologic complications have been reported with spinal transforaminal injections. Causes include intraneural injection,
plus embolization occlusion of the radicular artery with subsequent spinal cord infarction. 1 Optical coherence
tomography (OCT) is a non-invasive imaging modality, which is used to image tissue microstructure with very high
resolution (less than 20 microns) in real-time. With a view toward needle tip OCT visualization of the spinal
neuroforamen, we conducted animal studies to explore OCT imaging of paraspinal neurovascular structures. With
institutional animal care committee approval, we performed ex-vivo and in situ OCT studies in a euthanized dog, pig,
and rabbit. Image data was gathered on spinal nerve roots, dura, and brachial plexus. Two systems were used: frequency
domain OCT imaging system developed at California Institute of Technology, and time domain Imalux NIRIS system
with a 2.7 mm diameter probe. In a euthanized pig, excised dura was punctured with a 17-gauge Tuohy needle. FDOCT
dural images of the puncture showed a subsurface cone-shaped defect. In a rabbit in situ study, puncture of the dura with
a 26-gauge needle is imaged as a discontinuity. FDOCT imaging of both small artery and large arteries will be
presented, along with H&E and OCT images of the brachial plexus.
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