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Epidural steroid injections

Joseph S Hudson, Kingsley Abode-Iyamah, Yasunori Nagahama, Chandan G Reddy
BACKGROUND: Ionic contrast, if accidentally injected into the intrathecal space during routine imaging studies or interventional procedures, may significantly interfere with neuronal activity, potentially causing ascending tonic-clonic seizure syndrome and even death. As a result, ionic contrast is strictly contraindicated for intrathecal use. Rapid recognition of the condition followed by prompt management, typically involving aggressive cerebrospinal fluid (CSF) drainage, is critical to improving patient outcome...
October 17, 2016: World Neurosurgery
Gregory G Billy, Ji Lin, Mengzhao Gao, Mosuk X Chow
STUDY DESIGN: Retrospective clinical outcome analysis. OBJECTIVE: To evaluate and determine whether demographic, comorbid factors, or physical examination findings may predict the outcome of caudal epidural steroid injections in managing patients with chronic low back pain and radiculopathy SUMMARY OF BACKGROUND DATA:: The caudal epidural approach is commonly utilized with patients who are on anticoagulation or who have had prior lumbar surgery to treat L5 or S1 radiculopathies...
October 19, 2016: Clinical Spine Surgery
Jean-Denis Laredo, Elisabeth Laemmel, Eric Vicaut
No abstract text is available yet for this article.
2016: RMD Open
Fei Wang, Qian Zhou, Lizu Xiao, Juan Yang, Donglin Xong, Disen Li, LiPing Liu, Sigdha Ancha, Jianguo Cheng
BACKGROUND: We demonstrated a combination of pulsed radiofrequency (PRF) and cervical nerve root block (CNRB) via a posterior approach was superior to a transforaminal epidural steroid injection through the anterolateral approach for cervical radicular pain in a previous study. This randomized trial was conducted to determine the comparative efficacy between CNRB, PRF, and CNRB + PRF for cervical radicular pain. METHODS: A prospective and randomized design was used in this study...
October 14, 2016: Pain Practice: the Official Journal of World Institute of Pain
Alfred C Gellhorn, Pradeep Suri, Sean Rundell, Nathan Olafsen, M Jake Carlson, Steve Johnson, Adrielle Fry, Thiru Anaswammy, Christopher Gilligan, Bryan Comstock, Patrick Heagerty, Janna Friedly, Jeffrey G Jarvik
BACKGROUND: Minimal longitudinal data exist regarding the role of lumbar musculature in predicting back pain and function. In cross sectional study designs, there is often atrophy of the segmental multifidus muscle in subjects with low back pain compared with matched controls. However, the cross sectional design of these studies prevents drawing conclusions regarding whether lumbar muscle characteristics predict or modify future back pain or function. OBJECTIVE: The primary objective is to determine if the cross sectional area (CSA) of lumbar muscles predicts functional status or back pain at 6- or 12-month follow-up in older adults with spinal degeneration...
October 6, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
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...
September 30, 2016: Revista Brasileira de Anestesiologia
Duygu Tecer, Emre Adiguzel, Arif Kenan Tan, Mehmet Ali Taskaynatan
OBJECTIVE:  To explore the outcome differences of lumbar transforaminal epidural steroid injection (TFESI) according to magnetic resonance imaging (MRI) findings in patients with lumbar radicular pain. DESIGN:  Retrospective study. SETTING:  Single university-based interventional pain management unit. PATIENTS:  Fifty-nine patients who had lumbar radicular pain with a recent lumbar MRI and three-month follow-up were included...
October 2, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Stefan Hartveldt, Stein J Janssen, Kirkham B Wood, Thomas D Cha, Joseph H Schwab, Christopher M Bono, Louis G Jenis
STUDY DESIGN: Retrospective study. OBJECTIVE: To assess the relation between exposure to epidural steroid injection (ESI) before surgery and occurrence of surgical site infection (SSI) for degenerative lumbar spine conditions. SUMMARY OF BACKGROUND DATA: The effect of local ESI on the occurrence of SSI is controversial. METHODS: Patients who underwent surgery for degenerative lumbar spine conditions at two centers between 2005 and 2015 were identified...
October 1, 2016: Spine
Marco Lechmann, Andrea Rosskopf, Christine Ehrmann, Reto Sutter, Christian W A Pfirrmann, Cynthia K Peterson
OBJECTIVES: To determine whether specific MRI findings are related to outcomes after lumbar transforaminal epidural steroid injections (TFESI) and to assess the inter-rater reliability of imaging diagnosis. MATERIALS AND METHODS: A prospective outcomes study on 156 consecutive patients with 1-month follow-up outcomes data and MRI within 3 months of TFESI was conducted. Pain levels (numerical rating scale) (NRS) were recorded prior to injection. Overall 'improvement' was determined using the Patients Global Impression of Change (PGIC) scale and NRS data were collected at three time points post injection...
September 28, 2016: Skeletal Radiology
Janna L Friedly, Todd Edwards, Danielle Lavallee, Zoya Bauer, Una Makris, Srdj Nedeljkovic, Pradeep Suri, Jeffrey J Jarvik
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Gregory Decker, Berdale Colorado
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Janna L Friedly, Bryan A Comstock, Christopher J Standaert, Srdj Nedeljkovic, David J Kennedy, David M Sibell, Pradeep Suri, Venu Akuthota, Thiru M Annaswamy, Zoya Bauer, Jeffrey J Jarvik
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Chan Hong Park, Sang Ho Lee
BACKGROUND : Spinal stenosis is characterized by narrowing of the spinal canal, with mechanical compression of spinal nerve roots. The latter may cause low back pain and/or leg pain, as well as neurogenic claudication. Epidural steroid injection is commonly used to treat patients with lumbar spinal stenosis (LSS), but percutaneous epidural adhesiolysis has been utilized when symptoms prove refractory. Our goal was to assess the relationship between improvement shown on epidurogram and subjective patient response to adhesiolysis...
September 20, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Holger Joswig, Armin Neff, Christina Ruppert, Gerhard Hildebrandt, Martin Nikolaus Stienen
No abstract text is available yet for this article.
September 15, 2016: World Neurosurgery
E Shim, J W Lee, E Lee, T Im, Y Kang, J M Ahn, H S Kang
AIM: To evaluate the efficacy of facet joint injection (FJI) for patients with lumbar central canal stenosis (LCS) in comparison with epidural steroid injection (ESI) in the same individuals. MATERIAL AND METHODS: Two hundred and fifty-two patients who underwent both FJI and ESI for LCS between January 2014 and December 2014 were considered for enrolment in the study. A radiologist retrospectively conducted a chart review and recorded which injection was chosen as the third injection after sequential injections of FJI and ESI, and why clinicians chose the particular injection method...
October 8, 2016: Clinical Radiology
Ritesh Arvind Pandey
INTRODUCTION: Epidural steroid is an important modality in the conservative management of prolapsed lumbar disc and is being used for over 50 years. However, controversy still persists regarding their effectiveness in reducing the pain and improving the function with literature both supporting and opposing them are available. AIM: To study the efficacy of epidural steroid injection in the management of pain due to prolapsed lumbar intervertebral disc and to compare the effectiveness between caudal, transforaminal and interlaminar routes of injection...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Ashraf Eskandr, Sadik Abdel Maseeh
Purpose. Failed back surgery syndrome is a chronic pain condition requiring rapid, effective, and efficient management. This study evaluates the effect of adding dexmedetomidine to lumbar epidural steroids in patients with failed back surgery syndrome. Methods. Fifty patients suffering from failed back surgery syndrome were randomly assigned to one of two groups, receiving an epidural injection of 20 mL of either a mixture of betamethasone (14 mg) and bupivacaine 0.5 mg (group C) or a mixture of betamethasone (14 mg), bupivacaine 0...
2016: Anesthesiology Research and Practice
Kassandra Loewen, Colleen McKillop, Cai Lei Matsumoto, Robert Minty, Jonathon Morgan, Len Kelly
INTRODUCTION: We sought to document the efficacy of interlaminar epidural steroid injections (ESIs) for the relief of low back pain in a rural population. METHODS: We conducted a prospective observational cohort study with brief follow-up telephone interviews at 1, 3 and 6 months after interlaminar ESI. RESULTS: A total of 47 ESIs were administered to the 24 participants. In an intention-to-treat analysis, pain relief was achieved in 78.7%, 55...
2016: Canadian Journal of Rural Medicine
Adnan Bashir Bhatti, Sunny Kim
OBJECTIVE: The aim of this study is to evaluate the efficacy of the different types of epidural injections (EI) to prevent surgical intervention in patients suffering from chronic sciatica due to lumbar disc herniation (LDH). MATERIAL AND METHODS: Studies were identified by searching PubMed, MEDLINE, and Google Scholar to retrieve all available relevant articles. Lists of references of several systematic reviews were also used for scanning further references. Publications from the past ten years (2006-2016) were considered, and all studies selected were in the English language only...
2016: Curēus
V V Ramesh Chandra, B C M Prasad, C Krishna Mohan, T C Kalawat, V Satyanarayana, A Y Lakshmi
BACKGROUND: Low back pain is caused by a variety of conditions. When conventional imaging failed, single-photon emission computed tomography (SPECT) was superior to scintigraphy in identifying the pathology. Injection therapies are often helpful in treating the pathology. AIM: To determine the cause of chronic low backache in individuals with normal conventional imaging (radiographs, computed tomography and magnetic resonance imaging), to determine the specific pathology using scintigraphic studies and diagnostic blocks; and, to treat the individuals with various spinal injection techniques and determine their efficacy...
September 2016: Neurology India
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