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Epidural steroid injections

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https://www.readbyqxmd.com/read/29668635/effect-of-intradiscal-pulsed-radiofrequency-on-refractory-chronic-discogenic-neck-pain-a-case-report
#1
So Young Kwak, Min Cheol Chang
RATIONALE: Despite medication, exercise, and medical intervention, many patients complain of persistent discogenic neck pain. To manage discogenic neck pain, we performed intradiscal pulsed radiofrequency (PRF) stimulation in a patient with chronic discogenic neck pain refractory to oral medication and epidural steroid injection. PATIENT CONCERNS: A 26-year-old man presented with a numeric rating scale (NRS) score of 7 for chronic neck pain. His pain was worse when the neck was held in one position for a prolonged period...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29628602/anosmia-after-caudal-epidural-steroid-injection
#2
Ayhan Kaydu, Ebru Tarikçi Kiliç, Erhan Gökçek, Cem Kivilcim Kaçar
There are no reports for anosmia after caudal epidural steroid injections (CESIs). General anesthesia is among the reasons, but the reports up to date are extremely limited. There are no identifiable factors contributing to anosmia after epidural injection, so it is worth discussing. We present the case of a 50-year-old woman with no previous history of any sensory deficits. She experienced anosmia after CESI that had been performed due to her chronic low back pain and lasted for 4 months. Clinical and imaging studies did not reveal any pathology...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29621047/fluoroscopically-guided-lumbar-transforaminal-epidural-steroid-injection-procedural-technique
#3
David Stolzenberg, Junyoung J Ahn, Mark Kurd
Fluoroscopically guided lumbar transforaminal epidural steroid injections are indicated for the treatment of lumbar radicular pain that has failed more conservative options. This article details proper equipment and medications, patient positioning and set-up, step-by-step instructions for multiplanar fluoroscopic visualization, needle advancement and medication instillation, and postoperative management. Pearls and pitfalls are also discussed. In addition, an instructional procedure video accompanies this paper...
April 4, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29619790/just-think-about-pyogenic-spondylodiscitis-before-performing-the-epidural-steroid-injection-for-low-back-pain
#4
Yusuke Asakura
No abstract text is available yet for this article.
April 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29618074/letter-epidural-steroid-injection-induced-menorrhagia-an-under-recognized-complication-associated-with-a-common-spinal-intervention
#5
Ketan Yerneni, John F Burke, Lee A Tan
No abstract text is available yet for this article.
March 30, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29615600/persistent-hiccups-after-cervical-epidural-steroid-injection
#6
Ahmad Khaled Abubaker, Daher K Rabadi, Manal Kassab, Mohannad A Al-Qudah
BACKGROUND Hiccup is a rare complication after a cervical epidural steroid injection used in the treatment of chronic pain. A few studies have reported on the physiological and pharmacological aspects of hiccups after epidural steroid injection and there have been some case reports published. Our presented case report provides insight into the side effect of hiccups that can occur in association with cervical epidural analgesia, and will help inform anesthesiologist about this unpleasant complication. CASE REPORT We present a rare case of persistent hiccups after a cervical epidural steroid injection in a 60-year-old male patient with chronic pain due to disc protrusion in C3-C7...
April 4, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29595657/analysis-of-epidural-waveform-for-cervical-epidural-steroid-injections-confirmed-with-fluoroscopy
#7
Ji H Hong, Sung W Jung
The identification of epidural space with loss of resistance (LOR) is commonly performed. But it lacks specificity. Epidural pressure waveform analysis (EPWA) provides a simple confirmative adjunct for LOR. If the needle is located within the epidural space, measurement of the pressure at its tips shows a pulsatile waveform. Previous studies demonstrated satisfactory sensitivity and specificity of EPWA. However, success or failure of epidural injection was confirmed by the pinprick test, which is limited for patients in the setting of the pain clinic...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29576907/spinal-case-of-the-month-with-short-perspective-how-would-you-treat-this-l3-l4-synovial-cyst
#8
REVIEW
Nancy E Epstein
Background: In this new section, Case of the Month with Short Perspective from Surgical Neurology International, we want to see how various spine surgeons would approach different spinal pathologies. In this first case, an elderly male presented with 3 years of lower back pain and progressive neurogenic claudication with bilateral radiculopathy that had exacerbated over the prior 6 months. An outside physician performed a magnetic resonance (MR) study of the lumbar spine that showed a massive synovial cyst filling the spinal canal (e...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29565961/detection-of-intravascular-injection-during-cervical-transforaminal-epidural-injection-a-comparison-of-digital-subtraction-angiography-and-real-time-fluoroscopy
#9
Younghoon Jeon, Saeyoung Kim
BACKGROUND: Transforaminal epidural injection (TFEI) with local anesthetics and steroids are effective in treating spinal radicular pain. However, inadvertent intravascular injection can lead to severe neurologic complications. To reduce complications of intravascular injection, use of imaging modality, such as real-time fluoroscopy (RTF) or digital subtraction angiography (DSA), has been recommended. DSA is an imaging technique that can clearly visualize the blood vessels from surrounding bones or dense soft tissues by subtracting the pre-contrast image from the image after injecting contrast medium...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29565952/the-effect-of-bipolar-pulsed-radiofrequency-treatment-on-chronic-lumbosacral-radicular-pain-refractory-to-monopolar-pulsed-radiofrequency-treatment
#10
Dong Gyu Lee, Yun Woo Cho, Sang Ho Ahn, Min Cheol Chang
BACKGROUND: Patients with lumbosacral radicular pain may complain of persisting pain after monopolar pulsed radiofrequency (PRF) treatment. OBJECTIVE: We evaluated the effect of bipolar PRF stimulation of the dorsal root ganglion (DRG) in patients with chronic lumbosacral radicular pain who were unresponsive to both monopolar PRF stimulation of the DRG and transforaminal epidural steroid injection (TFESI). STUDY DESIGN: This is a prospective observational study...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29556817/a-review-of-current-treatment-options-for-coccygodynia
#11
REVIEW
Yasmin Elkhashab, Andrew Ng
PURPOSE OF REVIEW: Coccygodynia is pain within the coccyx area. The diagnosis is made clinically with symptoms of pain in the coccyx region and worsening pain in sitting position. The initial treatment is conservative therapy. For patients who do not respond to conservative therapies, there are further interventions available. This includes local injection of local anesthetics and steroids, neurolysis of sacral nerve roots, caudal epidural block, pulse radiofrequency (PRF), intra-rectal massage and manipulation, ganglion impar block, levator ani massage and stretching, coccyx manipulation, and coccygectomy...
March 19, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29548949/predictive-factors-of-successful-percutaneous-cervical-nucleoplasty-for-the-treatment-of-pain-with-cervical-herniated-disk
#12
Min Kyoung Kim, Sung Eun Sim, Yong-Chul Kim, Jung Soo Kim, Seok Min Kwon, Yongjae Yoo, Chang-Soon Lee, Jee Youn Moon
BACKGROUND: Percutaneous cervical nucleoplasty (PCN) is an effective treatment for cervical herniated intervertebral disc (C-HIVD). In this retrospective study, we evaluated clinical predictors that affect the successful outcome of PCN. METHODS: Fluoroscopy-guided PCN was conducted for C-HIVD by one pain physician. Successful outcome was defined as a combination of > 50% pain relief on the numerical rating scale (NRS) pain score, no increase in analgesics, and no cervical epidural steroid injection during the 3-month follow-up period...
March 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29541886/the-value-of-short-term-pain-relief-in-predicting-the-long-term-outcome-of-indirect-cervical-epidural-steroid-injections
#13
Holger Joswig, Armin Neff, Christina Ruppert, Gerhard Hildebrandt, Martin Nikolaus Stienen
BACKGROUND: The predictive value of short-term arm pain relief after 'indirect' cervical epidural steroid injection (ESI) for the 1-month treatment response has been previously demonstrated. It remained to be answered whether the long-term response could be estimated by the early post-interventional pain course as well. METHODS: Prospective observational study, following a cohort of n = 45 patients for a period of 24 months after 'indirect' ESI for radiculopathy secondary to a single-level cervical disk herniation (CDH)...
March 14, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29538204/spinal-cord-infarction-caused-by-sacral-canal-epidural-steroid-injection-a-case-report
#14
Gang Wang, Jing Liang, Zishan Jia, Lei Wan, Mingxia Yang
RATIONALE: Spinal cord infarction is one of the complications of epidural steroid injections (ESIs), but has only been reported in cervical vertebra by transforaminal injection and lumbar vertebra by transforaminal injection; and up to now, there is no reporting about spinal cord infarction caused by caudal injection. Here, we report a case. PATIENT CONCERNS: A 52-year-old man was admitted to our hospital. He was diagnosed as lumbar disc herniation in other hospital, and the patient suffered bilateral lower limb motor and sensory disorders after administration of caudal ESI...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29523042/the-retroneural-approach-an-alternative-technique-for-lumbar-transforaminal-epidural-steroid-injections
#15
Stefan Ignjatovic, Reza Omidi, Rahel A Kubik-Huch, Suzanne Anderson, Frank J Ahlhelm
Background Compared with other available injection techniques for lumbar transforaminal epidural steroid injections (LTFESIs), the traditionally performed subpedicular approach is associated with a higher risk of spinal cord infarction, a rare but catastrophic complication. Purpose To assess the short-term efficacy of the retroneural approach for computed tomography (CT)-guided LTFESIs with respect to different needle-tip positions. Material and Methods This retrospective analysis included 238 patients receiving 286 CT-guided LTFESIs from January 2013 to January 2016...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29520188/the-incidence-of-various-types-of-systemic-reactions-related-to-epidural-steroid-injections-a-prospective-observational-study
#16
Guen Young Lee, Joon Woo Lee, Jin S Yeom, Ki-Jeong Kim, Hyung-Ik Shin, Heung Sik Kang
Objective: To evaluate the incidence, types and association of systemic reactions after an epidural steroid injection (ESI) with patient demographics, ESI factors and repeated occurrence of an ESI. Materials and Methods: This prospective observational study was approved by the Institutional Review Board of our hospital, and written informed consent was obtained from all the participants. From October to December 2011, systemic reactions at 2 weeks after 960 ESIs among 885 patients were measured...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/29473813/tubular-approach-to-minimally-invasive-microdiscectomy-for-pediatric-lumbar-disc-herniation
#17
Julio D Montejo, Joaquin Q Camara-Quintana, Daniel Duran, Jeannine M Rockefeller, Sierra B Conine, Alyssa M Blaise, Kristopher T Kahle, Michael L DiLuna
OBJECTIVE Lumbar disc herniation (LDH) in the pediatric population is rare and exhibits unique characteristics compared with adult LDH. There are limited data regarding the safety and efficacy of minimally invasive surgery (MIS) using tubular retractors in pediatric patients with LDH. Here, the outcomes of MIS tubular microdiscectomy for the treatment of pediatric LDH are evaluated. METHODS Twelve consecutive pediatric patients with LDH were treated with MIS tubular microdiscectomy at the authors' institution between July 2011 and October 2015...
February 23, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29462057/segmental-spinal-myoclonus-complicating-lumbar-transforaminal-epidural-steroid-injection
#18
Stanley Sau Ching Wong, Qiu Qiu, Chi Wai Cheung
OBJECTIVE: Lumbar transforaminal epidural steroid injection is commonly used for treating lumbar radicular pain. We report a case of segmental spinal myoclonus that developed during lumbar transforaminal epidural injection with local anesthetic and steroid. CASE REPORT: A 58-year-old woman with failed back surgery syndrome presented with low back and right L3 and L4 radicular pain. As she had responded well previously to diagnostic selective nerve root injection with local anesthetic at the right L3 and L4 levels, lumbar transforaminal epidural steroid injection at the same levels was scheduled...
February 16, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29458195/human-dorsal-root-ganglion-pulsed-radiofrequency-treatment-modulates-cerebrospinal-fluid-lymphocytes-and-neuroinflammatory-markers-in-chronic-radicular-pain
#19
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
#20
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
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