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Retrospective analysis of 575 CT fluoroscopy-guided epidural injections was done to detect inadvertent arterial or venous injections. Intravascular injections occurred in 26% of cervical transforaminal injections, 9% of cervical interlaminar injections, 8% of lumbar transforaminal injections, and 2% of lumbar interlaminar injections. These findings are similar to previous reports using conventional fluoroscopy and demonstrate that intravascular injections may be detected with CT fluoroscopy.