The Lumbar Neural Foramen and Transforaminal Epidural Steroid Injections: An Anatomic Review With Key Safety Considerations in Planning the Percutaneous Approach

OBJECTIVE. The purpose of this article is to review the anatomy of the lumbar neural foramen and to describe techniques of transforaminal epidural steroid injections with emphasis on safety. Rare cases of paraplegia have been reported. CONCLUSION. Although no consensus currently exists about which approach is the safest, knowledge of the foraminal anatomy is a key consideration when choosing a needle approach for transforaminal epidural steroid injections.