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Fig. 4. Application of virtual simulation before performing transforaminal epidural injection in a patient with severe spinal deformity. (A) Axial plane of T2-weighted magnetic resonance imaging (MRI). Lumbar MRI of the patient revealed left sided L5 nerve root irritation due to severe spinal deformity seemed to be the cause of pain. (B) Three-dimensional virtual procedural planning. The virtual needle is placed in the most appropriate position. (C) Oblique view of the virtual X-ray image is saved where the needle presents as a pinpoint. (D) Anteroposterior view of the simulated virtual X-ray. (E) The patient’s oblique X-ray image during the procedure. (F) The patient’s X-ray image in the anteroposterior view during the procedure. White asterisk: needle, TP: transverse process, SAP: superior articular process, Dotted lines: contour of anatomical structures.
Korean J Pain 2022;35:403~412
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