CT angiography depicted lumbar spinal artery anatomic course: defining a safer zone for lumbar sympathetic and splanchnic blocks.

Using routine anatomic landmarks visible on CT imaging, we classified the anatomic course of low thoracic and lumbar spinal arteries originating from the aorta into the neural foraminal space. A safe recommendation to avoid intra-arterial injection for a splanchnic or lumbar sympathetic is to start above the pedicle and add a slight caudal angulation to the needle trajectory to avoid disc injury at the anterolateral vertebral body.