Yakov Perper

Dr, Department of Anesthesiology, Mount Sinai Hospital of Queens, Queens, NY, USA

Publications

• Research Article
  Algorithm for performing cervical epidural steroid injections with contrast spread technique
  Author(s): Yakov Perper*, Yuriy Ivanov and Stacy Serebnitsky
  
  Objective: To assist pain practitioners who perform Cervical Epidural Steroid Injections (CESI) with fluoroscopy only in recognizing possible contrast medium flow scenarios and in clinical decision making based on image findings. Methods and Results: A total of 1574 CESIs with Contrast Spread Technique (CST) were performed from August 1, 2014, to June 1, 2020, in our office. Through numerous observations and discussions, we came to some realizations that broaden our understanding of the technique. This knowledge eventually led to the creation of this algorithm and the writing of this paper. Different scenarios were illustrated with images from our practice. Special attention was given to key points of the algorithm: What might be the reasoning for the needle tip appearing to be inside the epidural space, but without a confirmatory medium flow? What is the optimal C-Arm angulat.. Read More»