Interlaminar Vs. Trasforaminal Epidural Injections Approaches An interlaminar epidural injection is the simplest approach to epidural injection. The fluoroscopic guidance (real time x-ray imaging) allows pain specialist physicians to precisely target interlaminar epidurals to specific spinal levels and today the interlaminar approach is used throughout the cervical, thoracic and lumbar spine. Interlaminar epidurals can be performed with minimal discomfort because the needle is placed into the ba