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Transforaminal epidural steroid injection

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https://www.readbyqxmd.com/read/28403104/effect-of-bipolar-pulsed-radiofrequency-on-refractory-chronic-cervical-radicular-pain-a-report-of-two-cases
#1
Min Cheol Chang
RATIONALE: Despite undergoing transforaminal epidural steroid injection (TFESI), many patients complain of persisting cervical radicular pain. For the management of chronic cervical radicular pain, clinicians are widely applying pulsed radiofrequency (PRF) stimulation to dorsal root ganglions (DRGs). To enhance the effect of PRF stimulation, we conducted bipolar PRF stimulation in 2 patients with chronic cervical radicular pain that was refractory to monopolar PRF and repeated TFESIs...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28392945/pitfalls-in-interventional-pain-medicine-hyponatremia-after-ddavp-for-a-patient-with-von-willebrand-disease-undergoing-an-epidural-steroid-injection
#2
Talal W Khan, Abdulraheem Yacoub
Desmopressin (DDAVP), a synthetic analog of vasopressin, has been used in patients with von Willebrand disease (VWD), mild hemophilia A, and platelet dysfunction to reduce the risk of bleeding associated with surgical and interventional procedures. We report the case of a patient with VWD presenting with a bulging disc and radicular pain that underwent transforaminal epidural steroid injections. Her course was complicated with the interval development of headaches and dizziness symptomatic of moderate hyponatremia, likely due to excessive fluid intake...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28349269/successful-outcomes-following-transforaminal-epidural-steroid-injections-for-c4-5-cervical-disc-prolapse-associated-with-profound-neurological-deficit
#3
Adam Meir, Keith Bush
PURPOSE: To show that with C5 radiculopathy and profound neurological deficit, good outcomes can be obtained with injection therapy. METHOD: We present two cases of cervical radiculopathy secondary to disc prolapse associated with profound neurological deficit. In both cases, cervical injection therapy was used as the primary management. RESULTS: The two cases presented were both male, 59 and 36 years, and were diagnosed on MRI imaging with C4/5 disc prolapses...
March 27, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28340495/residents-learning-curve-of-lumbar-transforaminal-epidural-steroid-injections
#4
Holger Joswig, Sarah Roberta Haile, Gerhard Hildebrandt, Martin Nikolaus Stienen
Background and Study Aims There is a paucity of literature on beginners' training and on its connection with patient safety for transforaminal epidural steroid injections (TFESIs). This study retrospectively assessed the learning curves and associated complications of neurosurgery residents never previously exposed to TFESI and compared them with experienced board-certified faculty neurosurgeons (BCFNs). Material and Methods Procedure time in minutes, dose-area product (DAP) in cGy*cm(2), periprocedural observations, and complications in 354 TFESIs for radicular pain secondary to lumbar disk herniation or lumbar spinal stenosis were extracted from operative notes and the electronic infiltration logbook in the per-injection format...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28298750/comparison-of-fluoroscopic-guided-transforaminal-epidural-injections-of-steroid-and-local-anaesthetic-with-conservative-management-in-patients-with-chronic-lumbar-radiculopathies
#5
Nandita Mehta, Misbah Salaria, A Q Salaria
BACKGROUND: Chronic lumbar radiculopathy is a common medical problem and the treatment modalities used over years have been many ranging from conservative or symptomatic management to open decompression surgery. This study was aimed at to compare two modalities of treatment, i.e., conservative and lumbar transforaminal epidural steroid injections (TFESIs). MATERIALS AND METHODS: A total of 120 patients of American Society of Anesthesiology class - (a healthy patient or a patient with mild systemic disease) were randomized to two groups...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28257294/the-1-year-results-of-lumbar-transforaminal-epidural-steroid-injection-in-patients-with-chronic-unilateral-radicular-pain-the-relation-to-mri-findings-and-clinical-features
#6
Harald Ekedahl, Bo Jönsson, Mårten Annertz, Richard B Frobell
OBJECTIVE: In patients with chronic radicular pain, we aimed to evaluate subgroup differences in 1-yr response to transforaminal epidural steroid injection. DESIGN: In this longitudinal cohort study of 100 subjects, 170 transforaminal epidural steroid injections were performed for 1 yr. The sample was stratified by type of disc herniation (protrusion n = 57, extrusion n = 27), by location of disc herniation (central/subarticular n = 60, foraminal n = 24), by grade of nerve root compression (low-grade compression n = 61, high-grade subarticular nerve compression n = 14, high-grade foraminal nerve compression n = 25), and by positive Slump test (n = 67)...
March 2, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28248888/comparison-between-bipolar-pulsed-radiofrequency-and-monopolar-pulsed-radiofrequency-in-chronic-lumbosacral-radicular-pain-a-randomized-controlled-trial
#7
RANDOMIZED CONTROLLED TRIAL
Min Cheol Chang, Yun Woo Cho, Sang Ho Ahn
BACKGROUND: Chronic lumbosacral radicular pain is a challenging medical problem with respect to therapeutic management. Many patients with lumbosacral radicular pain complain of persistent leg pain after transforaminal epidural steroid injection. Nowadays, pulsed radiofrequency (PRF) stimulation on the dorsal root ganglion (DRG) is widely used for controlling lumbosacral radicular pain. METHODS: We evaluated the effect of bipolar PRF on the DRG for the management of lumbosacral radicular pain...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28209578/intraforaminal-location-of-thoracolumbar-radicular-arteries-providing-an-anterior-radiculomedullary-artery-using-flat-panel-catheter-angiotomography
#8
L Gregg, D E Sorte, P Gailloud
BACKGROUND AND PURPOSE: Flat panel catheter angiotomography performed during the selective injection of intersegmental arteries offers a multiplanar assessment of the intraforaminal course of the radicular arteries providing an anterior radiculomedullary artery. Injury of anterior radiculomedullary arteries during transforaminal epidural steroid injections can result in spinal cord damage. Evaluations of the intraforaminal location of these arteries have so far been limited to anteroposterior views or the examination of cadaveric material...
February 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28203184/spinal-cord-infarction-after-cervical-transforaminal-epidural-steroid-injection-case-report-and-literature-review
#9
Jangsup Moon, Hyung-Min Kwon
INTRODUCTION: Transforaminal epidural steroid injection (TFESI) is a widely used nonsurgical procedure in the treatment of patients with radiculopathy. It is efficacious in relieving pain, but a number of complications are being reported. Recently, increasing frequency of major complications, such as spinal cord infarction and cerebral infarction, has been reported with the use of a particulate steroid within fluoroscopic-guided procedures. METHODS: We report a 49-year-old man with a history of chronic cervical radiculopathy, who experienced a devastating complication after TFESI...
January 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28168618/the-short-and-midterm-outcomes-of-lumbar-transforaminal-epidural-injection-with-preganglionic-and-postganglionic-approach-in-lumbosacral-radiculopathy-a-systematic-review-and-meta-analysis
#10
REVIEW
Saran Pairuchvej, Alisara Arirachakaran, Gun Keorochana, Komkrich Wattanapaiboon, Surapon Atiprayoon, Phoonyathorn Phatthanathitikarn, Jatupon Kongtharvonskul
The purpose of this study was to compare clinical outcomes after preganglionic versus ganglionic epidural steroid injection (ESI) using a systematic review and network meta-analysis. A systematic review and meta-regression was performed to compare postoperative outcomes between the two difference injection techniques. Relevant randomized controlled trials were identified from Medline and Scopus up to September 24, 2016. Sixteen out of 598 studies were eligible; 3, 2, and 3 studies were included in the pooling of outcomes including effectiveness, visual analog score (VAS), and complications (nerve root, injury, dural puncture, and intraneural injection)...
February 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28119838/the-prognostic-value-of-enhanced-mri-and-fluoroscopic-factors-for-predicting-the-effects-of-transforaminal-steroid-injections-on-lumbosacral-radiating-pain
#11
Yun Suk Jung, Jee Hyun Suh, Ha Young Kim, Kyunghoon Min, Yoongul Oh, Donghwi Park, Ju Seok Ryu
OBJECTIVE: To investigate the predictive value of enhanced-magnetic resonance imaging (MRI) and fluoroscopic factors regarding the effects of transforaminal epidural steroid injections (TFESIs) in low back pain (LBP) patients with lumbosacral radiating pain. METHODS: A total of 51 patients who had LBP with radiating pain were recruited between January 2011 and December 2012. The patient data were classified into the two groups 'favorable group' and 'non-favorable group' after 2 weeks of follow-up results...
December 2016: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28097241/extraforaminal-needle-tip-position-reduces-risk-of-intravascular-injection-in-ct-fluoroscopic-lumbar-transforaminal-epidural-steroid-injections
#12
Robinson K Yu, Gerritt M Lagemann, Anish Ghodadra, Vikas Agarwal
BACKGROUND: Lumbar transforaminal epidural steroid injection is a common and effective tool for managing lumbar radicular pain, although accidental intravascular injection can rarely result in paralysis. The purpose of this study is to determine the safest needle tip position for computed tomography (CT)-guided lumbar transforaminal epidural steroid injections as determined by incidence of intravascular injection. METHODS: Three radiologists, in consensus, reviewed procedural imaging for consecutive CT-fluoroscopic lumbar transforaminal epidural steroid injections performed during a 16-month period...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28094428/intra-operative-results-and-post-operative-clinical-outcomes-of-lumbar-microdiscectomy-in-patients-received-transforaminal-anterior-epidural-steroid-injection-earlier-for-lumbar-radiculopathy
#13
Sait Ozturk, Bekir Akgun, Fatih Serhat Erol, Selami Ates Onal, Metin Kaplan
AIM: We have aimed to describe the intra and postoperative results of patients who received transforaminal anterior epidural steroid injection (TAESI) prior to undergoing lumbar microdiscectomy. MATERIAL AND METHODS: 64 of 2461 patients evaluated who had received minimally invasive technique (MIT) for lumbar radiculopathy and who felt no relief after the procedures. 32 patients of them treated with different techniques other than TAESI and those receiving thrombolytic or anticoagulant drugs before microdiscectomy were excluded...
December 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28072802/efficacy-of-adjuvant-10-hypertonic-saline-in-transforaminal-epidural-steroid-injection-a-retrospective-analysis
#14
Eun Young Joo, Won Uk Koh, Seong-Soo Choi, Jae-Hyung Choi, Ho-Soo Ahn, Hye Joo Yun, Jin-Woo Shin
BACKGROUND: Chronic lower back pain with or without radiculopathy represents an important medical, social, and economic problem. Many treatment modalities and techniques, including surgery and epidural administration of steroids, have been used to manage this pain. Hypertonic saline, which has been used as an adjunct to percutaneous epidural adhesiolysis, can also be injected via a transforaminal approach in expectation of longer-lasting effects. OBJECTIVES: This study aimed to determine the effect of adding hypertonic saline to conventional transforaminal epidural steroid injections (TFEI) to provide pain relief for chronic radiculopathy patients...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28025353/imaging-determinants-of-clinical-effectiveness-of-lumbar-transforaminal-epidural-steroid-injections
#15
Timothy P Maus, Christine A El-Yahchouchi, Jennifer R Geske, Rickey E Carter, Timothy J Kaufmann, John T Wald, Felix E Diehn
OBJECTIVE: To examine associations between imaging characteristics of compressive lesions and patient outcomes after lumbar transforaminal epidural steroid injections (TFESIs) stratified by steroid formulation (solution versus suspension). DESIGN/SUBJECTS: Retrospective observational study, academic radiology practice. A 516-patient sample was selected from 2,634 consecutive patients receiving lumbar TFESI for radicular pain. METHODS: The advanced imaging study(s) preceding sampled TFESI were reviewed...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28025351/immediate-adverse-events-in-interventional-pain-procedures-a-multi-institutional-study
#16
Carrie M Carr, Christopher T Plastaras, Matthew J Pingree, Matthew Smuck, Timothy P Maus, Jennifer R Geske, Christine A El-Yahchouchi, Zachary L McCormick, David J Kennedy
SETTING: Interventional procedures directed toward sources of pain in the axial and appendicular musculoskeletal system are performed with increasing frequency. Despite the presence of evidence-based guidelines for such procedures, there are wide variations in practice. Case reports of serious complications such as spinal cord infarction or infection from spine injections lack appropriate context and create a misleading view of the risks of appropriately performed interventional pain procedures...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28017166/comparison-of-transforaminal-and-interlaminar-epidural-steroid-injections-for-the-treatment-of-chronic-lumbar-pain
#17
Serbülent Gökhan Beyaz
STUDY DESIGN: A cross-sectional study. OBJECTIVE: We compared the 12 month outcomes of fluoroscopically guided transforaminal epidural steroid injections with interlaminar epidural steroid injections for the treatment of chronic lumbar spinal pain. Chronic lower back pain is a multifactorial disorder with many possible etiologies. The lifetime prevalence of spinal pain is reportedly 65-80% in the neck and lower back. Epidural injection of corticosteroids is a commonly used intervention for managing chronic spinal pain...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27935769/fluoroscopically-guided-epidural-injections-of-the-cervical-and-lumbar-spine
#18
Euddeum Shim, Joon Woo Lee, Eugene Lee, Joong Mo Ahn, Yusuhn Kang, Heung Sik Kang
Advances in imaging and the development of injection techniques have enabled spinal intervention to become an important tool in managing chronic spinal pain. Epidural steroid injection (ESI) is one of the most widely used spinal interventions; it directly delivers drugs into the epidural space to relieve pain originating from degenerative spine disorders-central canal stenoses and neural foraminal stenoses-or disk herniations. Knowledge of the normal anatomy of the epidural space is essential to perform an effective and safe ESI and to recognize possible complications...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27915069/systematic-review-of-the-efficacy-of-particulate-versus-nonparticulate-corticosteroids-in-epidural-injections
#19
REVIEW
Priyesh Mehta, Isaac Syrop, Jaspal Ricky Singh, Jonathan Kirschner
OBJECTIVE: To systematically analyze published studies in regard to the comparative efficacy of particulate versus nonparticulate corticosteroids for cervical and lumbosacral epidural steroid injections (ESI) in reducing pain and improving function. TYPE: Systematic review. LITERATURE SURVEY: MEDLINE (Ovid), EMBASE, and Cochrane databases were searched from the period of 1950 to December 2015. METHODOLOGY: Criteria for inclusion in this review were (1) randomized controlled trials and (2) retrospective studies that compared particulate versus nonparticulate medication in fluoroscopically guided injections via a transforaminal (TF) or interlaminar (IL) approach...
November 30, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27906952/conus-medullaris-infarction-after-a-right-l4-transforaminal-epidural-steroid-injection-using-dexamethasone
#20
Christopher G Gharibo, Michael Fakhry, Sudhir Diwan, Alan D Kaye
BACKGROUND: For decades, epidural steroid injections have been an effective tool in the management of many pain related conditions, including lumbar radiculopathy. Transforaminal epidural steroid injections in particular have been reported to potentially result in central nervous system infarctions which have not been reported with interlaminar epidural steroid injections, while providing comparable efficacy. This rare, catastrophic complication has been attributed by some authors to be due to vascular injury secondary to vasospasm, thrombus formation, dissection, as well as concerns with placing the needle at the so-called "safe triangle...
November 2016: Pain Physician
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