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Epidural steroid injection

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https://www.readbyqxmd.com/read/27906952/conus-medullaris-infarction-after-a-right-l4-transforaminal-epidural-steroid-injection-using-dexamethasone
#1
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
https://www.readbyqxmd.com/read/27906944/the-safety-of-ct-guided-epidural-steroid-injections-in-an-older-patient-cohort
#2
Andrew J Fenster, Kevin Fernandes, Alan L Brook, Todd Miller
BACKGROUND: Epidural steroid injections (ESIs) are a common method for treating lower back pain, which is one of the most prevalent health-related complaints in the adult US population. Although the safety of CT-guided ESIs has been extensively studied in adults, there is limited data concerning the procedure's safety profile in an older patient population. OBJECTIVE: This retrospective study analyzed safety data among a single-center cohort of patients > 65 years-old who received one or more CT-guided interlaminar ESIs from 2012 to 2015...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27891040/inadvertent-injection-of-potassium-chloride-instead-of-sodium-chloride-during-treatment-of-chronic-low-back-ache-with-epidural-injection-leading-to-paraplegia
#3
Rahul Ranjan, Naiyer Asif, Sohail Ahmad, Syed Ifthekar
Epidural injection of steroid is given for back pain resistant to other conservative management. Normal saline (NS) is used as diluent in 80 mg methylprednisolone and a local anesthetic. Due to a similar looking ampoule of NS and potassium chloride (KCl), there is a probability of accidental use of KCl instead of NS. We present a case of a 50-year-old male patient having low back ache refractory to other conservative treatments. Epidural injection of steroid was given, but accidently KCl was mixed with methylprednisolone instead of NS...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27882818/comparison-of-lumbosacral-transforaminal-epidural-steroid-injection-techniques-in-terms-of-radiation-safety
#4
Duygu Tecer, Evren Yasar, Emre Adiguzel, Mehmet Ali Taskaynatan, Birol Balaban, Arif Kenan Tan
AIM: To investigate the difference in radiation exposure to the patients between oblique and posteroanterior view, initial approach techniques in fluoroscopy-guided lumbosacral transforaminal epidural steroid injections. PATIENTS & METHODS: Total amount of Kerma area product, elapsed time of the procedure and fluoroscopy time were obtained from medical records retrospectively. RESULTS: 28 patients were included in each group. Fluoroscopy time was significantly lower in group 1, but there was no statistically significant difference in terms of procedure time and Kerma area product...
November 24, 2016: Pain Management
https://www.readbyqxmd.com/read/27858682/the-effectiveness-of-transforaminal-epidural-steroid-injections-on-radicular-pain-functionality-psychological-status-and-sleep-quality-in-patients-with-lumbar-disc-herniation
#5
Mustafa Akif Sariyildiz, İbrahim Batmaz, Levent Yazmalar, Mehmet Güneş, Yahya Turan
BACKGROUND: The significance of fluoroscopy-guided transforaminal epidural steroid injections (TFESI) in the treatment of lumbar disc herniation (LDH) is well known. The aim of our study is to investigate the effectiveness of TFESI on radicular pain, functionality, psychological status, and sleep quality in patients with LDH. METHODS: Seventy-five LDH patients (36 males, 39 females) were enrolled in the study. All patients received a fluoroscopically guided TFESI (betamethasone 40 mg, lidocaine 2%)...
November 8, 2016: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/27847727/acute-paraplegia-after-lumbar-steroid-injection-in-patients-with-spinal-dural-arteriovenous-fistulas-case-reports
#6
Sunwoong Kim, Yuseong Choi, Jinyoung Park, Duk Hyun Sung
Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal vascular malformations. However, SDAVFs are still underdiagnosed entities because their clinical symptoms are usually non-specific, as they include low back pain or radiating pain to the limb. There have been several reports of acute paraplegia after lumbar epidural steroid injections in patients with SDAVFs. We present 4 patients with SDAVFs who received lumbar steroid injection. Among the 4 cases, acute paraplegia developed in 2 cases that received a larger volume of injectate than the other cases...
October 2016: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27827521/ultrasonography-for-neuraxial-blocks-a-review-of-the-evidence
#7
Maria F Elgueta, Silvia Duong, Roderick J Finlayson, De Qh Tran
INTRODUCTION: This narrative review summarizes the evidence derived from randomized controlled trials (RCTs) pertaining to the use of adjunctive ultrasonography (US) for neuraxial blocks. EVIDENCE ACQUISITION: The literature search was conducted using the MEDLINE, EMBASE and PUBMED databases. For the MEDLINE and EMBASE searches, the MESH terms "ultrasonography" and key word "ultrasound" were queried; using the operator "and", they were combined with the MESH terms "neuraxial block", "epidural anesthesia", "epidural analgesia", "spinal anesthesia", "spinal analgesia", "intrathecal anesthesia", "intrathecal analgesia", "caudal anesthesia", and "caudal analgesia"...
November 9, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27796650/the-value-of-short-term-pain-relief-in-predicting-the-1-month-outcome-of-indirect-cervical-epidural-steroid-injections
#8
Holger Joswig, Armin Neff, Christina Ruppert, Gerhard Hildebrandt, Martin Nikolaus Stienen
BACKGROUND: Clinical management after epidural steroid injections (ESI) of patients with radiculopathy secondary to a cervical disc herniation (CDH) is uncertain. This study aims to determine whether short-term arm pain alleviation following computed tomography-guided 'indirect' cervical ESI can predict the 1-month outcome. METHODS: We conducted a prospective observation of 45 consecutive patients at a tertiary radiological department. Study components were visual analog scale arm and neck pain at baseline, 15, 30, and 45 min, 1, 2, and 4 h, on days 1-14, 1 month, and at 1 year...
October 28, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27792054/evaluation-and-treatment-of-lumbar-facet-cysts
#9
Barrett S Boody, Jason W Savage
Lumbar facet cysts are a rare but increasingly common cause of symptomatic nerve root compression and can lead to radiculopathy, neurogenic claudication, and cauda equina syndrome. The cysts arise from the zygapophyseal joints of the lumbar spine and commonly demonstrate synovial herniation with mucinous degeneration of the facet joint capsule. Lumbar facet cysts are most common at the L4-L5 level and often are associated with spondylosis and degenerative spondylolisthesis. Advanced imaging studies have increased diagnosis of the cysts; however, optimal treatment of the cysts remains controversial...
December 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27790553/efficacy-of-platelet-rich-plasma-via-lumbar-epidural-route-in-chronic-prolapsed-intervertebral-disc-patients-a-pilot-study
#10
Rohan Bhatia, Gaurav Chopra
INTRODUCTION: Lumbar radiculopathy is a major health problem often treated by surgery or guided lumbar epidural steroids for pain relief. We have used Platelet Rich Plasma (PRP) a novel therapeutic tool of autologous nature that has emerged strongly in recent years to treat patients of prolapsed intervertebral disc. AIM: To evaluate the efficacy of PRP via interlaminar epidural route in treatment of pain in patients with prolapsed inter vertebral disc. MATERIALS AND METHODS: Ten patients were injected with five ml of autologous platelet rich plasma under fluoroscopic guidance via interlaminar lumbar epidural injection into area of affected nerve root...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27779490/paraplegia-following-lumbar-epidural-steroid-injection-in-a-patient-with-a-spinal-dural-arteriovenous-fistula
#11
Thiru M Annaswamy, Jared Worchel
We report a patient with a previously undiagnosed spinal dural arteriovenous fistula (SDAVF) who became acutely paraplegic following a lumbar epidural steroid injection for lumbar spinal stenosis. Magnetic resonance imaging showed multiple flow voids and serpentine vessels on the cord surface with cord edema extending from T3 through the conus. Spinal angiography confirmed an SDAVF fed by the left lateral sacral artery, which was subsequently endovascularly embolized, and the patient had a partial return of function...
October 22, 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/27777051/patient-reported-outcomes-after-lumbar-epidural-steroid-injection-for-degenerative-spine-disease-in-depressed-versus-non-depressed-patients
#12
Elliott J Kim, Silky Chotai, David P Stonko, Joseph B Wick, Byron J Schneider, Matthew J McGirt, Clint J Devin
BACKGROUND CONTEXT: Non-operative modalities such as lumbar epidural steroid injections (LESI) are often used in the setting of lumbar spine disorders where other conservative measures have failed. Concomitant depression can lead to worse outcomes in lumbar spine pathology. A number of studies have demonstrated an association between preoperative depression and poor outcomes following surgery but the effect of depression on outcomes following non-operative modalities is poorly understood...
October 21, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27776101/the-risk-benefit-ratio-why-perform-a-cervical-epidural-steroid-injection
#13
Andrew J Engel
No abstract text is available yet for this article.
November 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27774361/application-of-the-harms-technique-to-treat-undiagnosed-intractable-c1-c2-unilateral-neck-pain-a-case-report
#14
Adnan Bashir Bhatti, Sunny Kim
A 79-year-old female presented with incapacitating chronic neck pain. The patient's pain which was greatest on the left side persisted for 18 months and was described as stabbing in nature (10/10 intensity). In addition to her neck pain, the patient described having frequent headaches. After six weeks of physical therapy and undergoing a rhizotomy procedure, she showed no prolonged improvement. An epidural steroid injection provided only temporary pain relief and was followed by a successful posterior fusion using the Harms technique with iliac crest autogenous bone grafting and placement of polyaxial screws in the C1 lateral masses and C2 pedicles...
September 21, 2016: Curēus
https://www.readbyqxmd.com/read/27765719/accidental-intrathecal-injection-of-ionic-contrast-case-report-and-review-of-the-literature
#15
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
https://www.readbyqxmd.com/read/27764056/predictive-factors-of-the-effectiveness-of-caudal-epidural-steroid-injections-in-managing-patients-with-chronic-low-back-pain-and-radiculopathy
#16
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
https://www.readbyqxmd.com/read/27752359/serious-neurological-events-complicating-epidural-injections-of-glucocorticoid-suspensions-evidence-for-a-direct-effect-of-some-particulate-steroids-on-red-blood-cells
#17
Jean-Denis Laredo, Elisabeth Laemmel, Eric Vicaut
No abstract text is available yet for this article.
2016: RMD Open
https://www.readbyqxmd.com/read/27739217/a-randomized-comparative-study-of-pulsed-radiofrequency-treatment-with-or-without-selective-nerve-root-block-for-chronic-cervical-radicular-pain
#18
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
https://www.readbyqxmd.com/read/27721002/lumbar-muscle-cross-sectional-areas-do-not-predict-clinical-outcomes-in-adults-with-spinal-stenosis-a-longitudinal-study
#19
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
https://www.readbyqxmd.com/read/27697354/-comparison-of-transforaminal-and-interlaminar-epidural-steroid-injections-for-the-treatment-of-chronic-lumbar-pain
#20
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
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