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Epidural steroid injections

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https://www.readbyqxmd.com/read/29458195/human-dorsal-root-ganglion-pulsed-radiofrequency-treatment-modulates-cerebrospinal-fluid-lymphocytes-and-neuroinflammatory-markers-in-chronic-radicular-pain
#1
Basabjit Das, Melissa Conroy, David Moore, Joanne Lysaght, Connail McCrory
Radicular pain is a common cause of disability. Traditionally treatment has been either epidural steroid injection providing short-term relief or surgery with associated complications. Pulsed radiofrequency (PRF) applied to the Dorsal Root Ganglion (DRG) is a minimally invasive day-care treatment, which is gaining significant clinical acceptance in a selective group of patients with pure radicular pain. Greater insights into the immunomodulatory effects of this procedure may help to further optimise its application and find alternative treatment options...
February 16, 2018: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29419657/neuroinflammation-of-the-spinal-cord-and-nerve-roots-in-chronic-radicular-pain-patients
#2
Daniel Albrecht, Shihab Ahmed, Norman Kettner, Ronald Borra, Julien Cohen-Adad, Hao Deng, Timothy Houle, Arissa Opalacz, Sarah Roth, Marcos Vidal Melo, Lucy Chen, Jianren Mao, Jacob Hooker, Marco L Loggia, Yi Zhang
Numerous preclinical studies support the role of spinal neuroimmune activation in the pathogenesis of chronic pain, and targeting glia (e.g., microglia/astrocyte)- or macrophage-mediated neuroinflammatory responses effectively prevents or reverses the establishment of persistent nocifensive behaviors in laboratory animals. However, thus far the translation of those findings into novel treatments for clinical use has been hindered by the scarcity of data supporting the role of neuroinflammation in human pain...
February 5, 2018: Pain
https://www.readbyqxmd.com/read/29410375/the-efficacy-of-cauda-epidural-steroid-injections-with-targeted-indwelling-catheter-and-manipulation-in-managing-patients-with-lumbar-disc-herniation-with-radiculopathy-a-prospective-randomized-single-blind-controlled-trial
#3
Mengchen Yin, Wen Mo, Haiyang Wu, Jinhai Xu, Jie Ye, Ni Chen, Anastasia Sulindro Marla, Junming Ma
No abstract text is available yet for this article.
February 1, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29396693/efficacy-and-outcome-predictors-of-fluoroscopy-guided-facet-joint-injection-for-spondylolysis
#4
Woo Young Kang, Joon Woo Lee, Eugene Lee, Yusuhn Kang, Joong Mo Ahn, Heung Sik Kang
OBJECTIVE: To assess the efficacy of fluoroscopy-guided facet joint injection for symptomatic spondylolysis and to analyze the outcome predictors. MATERIALS AND METHODS: This study included 108 patients who underwent fluoroscopy-guided facet joint steroid injection for symptomatic spondylolysis with follow-up medical records from January 2013 to December 2016. Among them, 47 patients underwent concomitant epidural steroid injection. Response to injection was assessed at the initial follow-up...
February 2, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29394207/systemic-effects-of-epidural-steroid-injections-for-spinal-stenosis
#5
Janna L Friedly, Bryan A Comstock, Patrick J Heagerty, Zoya Bauer, Micol S Rothman, Pradeep Suri, Ryan Hansen, Andrew L Avins, Srdjan S Nedeljkovic, David R Nerenz, Venu Akuthota, Jeffrey G Jarvik
This analysis of the Lumbar Epidural steroid injections for Spinal Stenosis (LESS) multi-center randomized controlled trial data identifies the degree of and risk factors for cortisol suppression following epidural steroid injections in older adults with spinal stenosis. 400 patients aged > 50 years with back or leg pain and central lumbar spinal stenosis completed baseline demographic and psychosocial measures. Morning serum cortisol levels were measured at baseline and 3 weeks after initial injection. Patients were randomized to receive epidural injections of either local anesthetic with corticosteroid (n = 200) or local anesthetic only (n = 200)...
January 30, 2018: Pain
https://www.readbyqxmd.com/read/29374352/image-guidance-technologies-for-interventional-pain-procedures-ultrasound-fluoroscopy-and-ct
#6
REVIEW
Dajie Wang
Chronic pain is a common medical condition. Patients who suffer uncontrolled chronic pain may require interventions including spinal injections and various nerve blocks. Interventional procedures have evolved and improved over time since epidural injection was first introduced for low back pain and sciatica in 1901. One of the major contributors in the improvement of these interventions is the advancement of imaging guidance technologies. The utilization of image guidance has dramatically improved the accuracy and safety of these interventions...
January 26, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29357335/outcome-of-transforaminal-epidural-steroid-injection-according-to-the-severity-of-lumbar-foraminal-spinal-stenosis
#7
Min Cheol Chang, Dong Gyu Lee
BACKGROUND: Lumbar foraminal spinal stenosis (LFSS) is a common cause of radicular pain in the lower extremities. Transforaminal epidural steroid injection (TFESI) is being used widely for controlling radicular pain induced by LFSS. The efficacy of TFESI has been demonstrated in previous studies. However, no study has evaluated the outcome of TFESI according to the severity of LFSS. OBJECTIVE: In this study, we evaluated the outcome of TFESI in patients with chronic lumbar radicular pain due to LFSS according to the severity of LFSS by using magnetic resonance imaging (MRI)...
January 2018: Pain Physician
https://www.readbyqxmd.com/read/29357331/reducing-radiation-exposure-in-lumbar-transforaminal-epidural-steroid-injections-with-pulsed-fluoroscopy-a-randomized-double-blind-controlled-clinical-trial
#8
Edward Braun, Andrew M Sack, Dawood Sayed, Smith Manion, Brian Hamm, Michael Brimacombe, Michael Tollette, Talal W Khan, Walter Orr, Andrea Nicol
BACKGROUND: Fluoroscopy-guided lumbar transforaminal epidural steroid injections (L-TFESI) result in radiation exposure that carries risks to patients, physicians, and procedural staff. OBJECTIVE: We aim to evaluate the feasibility of using pulsed fluoroscopy to safely reduce radiation exposure during L-TFESI. STUDY DESIGN: This is a prospective, double-blind, randomized controlled trial. SETTING: This study took place in a single-center, academic, outpatient interventional pain management clinic...
January 2018: Pain Physician
https://www.readbyqxmd.com/read/29322966/the-influence-of-adjunctive-caudal-epidural-steroid-injection-on-the-therapeutic-effect-of-transforaminal-epidural-steroid-injection
#9
Atilla Kircelli, Tufan Cansever, Cem Yılmaz
BACKGROUND: Epidural steroid injection is widely used to treat the short and long-term symptoms of low back and radicular pain. To the best of our knowledge, the influence of transforaminal epidural steroid injection (TFSI) combined with caudal epidural steroid injection (CESI) on pain intensity, patient satisfaction, and quality of life in lumbar radiculopathy has not been examined. AIM: To evaluate the short and long-term efficacy of TFSI, and TFSI combined with CESI (TFSI + CESI) in patients with lumbar radiculopathy...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29322309/the-global-spine-care-initiative-a-summary-of-guidelines-on-invasive-interventions-for-the-management-of-persistent-and-disabling-spinal-pain-in-low-and-middle-income-communities
#10
REVIEW
Emre Acaroğlu, Margareta Nordin, Kristi Randhawa, Roger Chou, Pierre Côté, Tiro Mmopelwa, Scott Haldeman
PURPOSE: The purpose of this study was to synthesize recommendations on the use of common elective surgical and interventional procedures for individuals with persistent and disabling non-radicular/axial with or without myelopathy, radicular back pain, cervical myelopathy, symptomatic spinal stenosis, and fractures due to osteoporosis. This review was to inform a clinical care pathway on the patient presentations where surgical interventions could reasonably be considered. METHODS: We synthesized recommendations from six evidence-based clinical practice guidelines and one appropriate use criteria guidance for the surgical and interventional management of persistent and disabling spine pain...
January 10, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29319605/epidural-hematoma-following-interlaminar-epidural-injection-in-patient-taking-aspirin
#11
Rebecca A Sanders, Markus A Bendel, Susan M Moeschler, William D Mauck
OBJECTIVE: We present a case report of a patient who developed an epidural hematoma following an interlaminar epidural steroid injection with no risk factors aside from old age and aspirin use for secondary prevention. CASE REPORT: A 79-year-old man developed an epidural hematoma requiring surgical treatment following an uncomplicated interlaminar epidural steroid injection performed for neurogenic claudication. In the periprocedural period, he continued aspirin for secondary prophylaxis following a myocardial infarction...
January 9, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29304236/the-effect-of-epidural-steroid-injections-on-bone-mineral-density-and-vertebral-fracture-risk-a-systematic-review-and-critical-appraisal-of-current-literature
#12
Panagiotis Kerezoudis, Lorenzo Rinaldo, Mohammed Ali Alvi, Christine L Hunt, Wenchun Qu, Timothy P Maus, Mohamad Bydon
Objective: The aim of this paper is to review the available literature investigating the effect of epidural steroid injections (ESIs) on bone mineral density (BMD) and vertebral fracture risk. Study design: Systematic review of current literature. Methods: The sources of the data were PubMed, Embase, Cochrane, and Scopus. Papers included in the review were original research articles in peer-reviewed journals. Results: A total of 7,233 patients (eight studies) with a mean age ranging between 49 and 74 years and an average follow-up between six and 60 months were studied...
January 2, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29282848/radiation-dose-exposure-for-lumbar-transforaminal-epidural-steroid-injections-and-facet-joint-blocks-under-ct-versus-fluoroscopic-guidance
#13
Paolo Maino, Stefano Presilla, Paola A Colli Franzone, Sander M J van Kuijk, Roberto S G M Perez, Eva Koetsier
BACKGROUND: Transforaminal epidural steroid injections (TFESIs) and facet joint blocks can be performed under fluoroscopy or computed tomography (CT) guidance. The purpose of this retrospective cohort study was to compare patient radiation dose for lumbar TFESIs and facet joint blocks under CT guidance versus fluoroscopic guidance. METHODS: The primary outcome of this retrospective cohort study was the difference between the estimated effective dose (ED) of CT guidance and fluoroscopic guidance for TFESIs and facet joint blocks...
December 28, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29274452/visualization-of-needle-tip-localization-by-ultrasound-guidance-with-contrast-bubble-in-lumbar-selective-nerve-root-block-clinical-pilot-study
#14
Sorayouth Chumnanvej, Kitipat Kittayapirom, Siriluk Chumnanvej
BACKGROUND: Epidural steroid injection for low back and leg pain has been shown to result in a positive clinical outcome. Lumbosacral selective nerve root block (SNRB) via a transforaminal approach is commonly performed under fluoroscopic guidance. However, ultrasound guidance is an alternative to overcome the radiologic disadvantages. This study examined the accuracy of needle-tip localization under ultrasound guidance with a contrast bubble, compared with fluoroscopic guidance. OBJECTIVE: The primary objectives were to envisage the needle-tip localization with an air bubble by ultrasound and also to determine the accuracy of needle-tip location in transforaminal lumbar SNRB for low back and leg pain patients who were not surgical candidates...
December 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29240738/outcome-of-acute-hospital-admission-for-non-specific-low-back-pain-what-is-the-role-of-mri
#15
Eric Ta Lim, Jean-Claude Theis
BACKGROUND: Low back pain is a common worldwide condition, affecting most people during their lifetime. Various imaging modalities are being used to assist clinicians in diagnosing and thus, aid in formulating a suitable management plan. Extensive research has been carried out in assessing this condition due to its high prevalence, with many guidelines published internationally. AIM: To determine whether MRI imaging influences the management of patients admitted with acute, non-specific low back pain between 1 January 2013 and 31 December 2015...
December 15, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29189309/lumbar-transforaminal-epidural-steroid-injection-in-patients-with-chronic-unilateral-radicular-pain
#16
Tomoyuki Kawada
No abstract text is available yet for this article.
November 20, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29189307/lumbar-transforaminal-epidural-steroid-injection-in-patients-with-chronic-unilateral-radicular-pain
#17
Harald Ekedahl, Bo Jönsson, Richard B Frobell
No abstract text is available yet for this article.
November 20, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29177632/the-use-of-lumbar-epidural-injection-of-platelet-lysate-for-treatment-of-radicular-pain
#18
Christopher Centeno, Jason Markle, Ehren Dodson, Ian Stemper, Matthew Hyzy, Christopher Williams, Michael Freeman
BACKGROUND: Epidural steroid injections (ESI) are the most common pain management procedure performed in the US, however evidence of efficacy is limited. In addition, there is early evidence that the high dose of corticosteroids used can have systemic side effects. We describe the results of a case series evaluating the use of platelet lysate (PL) epidural injections for the treatment of lumbar radicular pain as an alternative to corticosteroids. METHODS: Registry data was obtained for patients (N = 470) treated with PL epidural injections presenting with symptoms of lumbar radicular pain and MRI findings that were consistent with symptoms...
November 25, 2017: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29173666/lumbar-epidural-steroid-injections
#19
REVIEW
Carlos E Rivera
Lumbar epidural steroid injections under fluoroscopic guidance are used very commonly for the treatment of low back and lower extremity radicular pain. These procedures have been shown to be effective for pain relief in the short term and are relatively safe. The indications, evidence, and safety considerations for 2 different techniques-namely, interlaminar and transforaminal-are discussed.
February 2018: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29173662/image-and-contrast-flow-pattern-interpretation-for-attempted-epidural-steroid-injections
#20
REVIEW
Michael B Furman, Anthony A Cuneo
Fluoroscopically guided, contrast-enhanced epidural steroid injections (ESIs) are frequently performed for radicular symptoms. Interventionalists performing these procedures should have a thorough and detailed understanding of spinal anatomy to safely and effectively deliver the desired injectate to the targeted site. Being able to differentiate epidural from nonepidural contrast flow is vital as is recognizing flow to undesired locations. This article summarizes the characteristics that distinguish between ideal epidural flow patterns and nonideal subarachnoid, intradural, and other suboptimal contrast flow patterns...
February 2018: Physical Medicine and Rehabilitation Clinics of North America
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