The potential for disaster is always present and is enhanced when variations in anatomy or selective techniques are contemplated. A more contentious issue is the necessity of fluoroscopy. Fluoroscopic guidance is invaluable when using translaminar or transforaminal approaches. Imaging equipment is essential when a procedure targets a specific localization or spread of medication. Many believe that fluoroscopy enhances the accuracy, safety and therapeutic benefit of epidural interventions.
Fluoroscopy is invaluable to identify interspace location and helps confirm depth.
Dye studies can precisely distinguish subcutaneous, intravascular or subarachnoid instillation. The rationale for having fluoroscopy available for CEIs and TEIs is sound and well founded. Thin-needle techniques often require fluoroscopic guidance. Next year, HCFA's hit list will again be revisited. The logic of currently excluded pain procedures is very hard to comprehend.