Selective nerve root and epidural steroid injections are safe outpatient procedures, best performed by using image guidance in conjunction with contrast agents. Use of the techniques described in this chapter will minimize rates of both minor and serious complication. The author has performed several thousand procedures in an outpatient setting without any serious complications.37 Optimal safety and efficacy require an excellent working knowledge of the radiographic anatomy and the imaging equipment used to perform these procedures. Several studies have demonstrated the difficulty and uncertainty of obtaining an accurate injection without imaging guidance. Radiologists who are well trained in the performance of image-guided percutaneous injection procedures are thus best qualified to perform these procedures in a safe and efficacious manner. When properly performed, these procedures have a clinically established role in the management of neck and back pain.

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