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This does not mean zero drug reaches CNS targets, but it does mean the fraction is likely small and the pharmacokinetic profile is poorly characterized for that route

B12 is safe on its own, but a few conditions call for extra care, which is why a provider reviews your history before treatment: Leber's hereditary optic neuropathy, a rare inherited eye condition, where certain forms of B12 may be a concern for the optic nerve

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doi:10.1212/CPJ.0000000000000043 Interlaminar route: In this technique, the needle is inserted from the back of the spine and the medication is deposited into the epidural space