 At this point using a oblique fluoroscopic projection and gun-barrel technique, a 22-gauge 3.5 inch spinal needle was placed at the superior articular process of L5 on the right, stepped off laterally and redirected medially into the intervertebral foramen to the L4 nerve root. 
At this point using a oblique fluoroscopic projection and gun - barrel technique , a 22 - gauge 3.5 inch spinal needle was placed at the superior articular process of L5 on the right , stepped off laterally and redirected medially into the intervertebral foramen to the L4 nerve root .