Technical report presents a simplified fluoroscopic technique to enhance S1 epidural injections, suggesting improved accuracy.
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.
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Kumar et al. (2026) studied this question.
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