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Epidural injection

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https://www.readbyqxmd.com/read/29883820/extensive-spinal-adhesive-arachnoiditis-after-extradural-spinal-infection-spinal-dura-mater-is-no-barrier-to-inflammation
#1
Theresa Krätzig, Marc Dreimann, Klaus Christian Mende, Ingo Königs, Manfred Westphal, Sven Oliver Eicker
BACKGROUND: Spinal adhesive arachnoiditis (SAA) is an inflammatory process of the meninges. Cystic changes and cicatrisation may lead to neurological deficits and immobilization. Therapy is difficult and often unsatisfactory. We describe eight cases of extensive SAA following extradural spinal infection. METHODS: 238 patients with epidural abscess or osteomyelitis were treated at our institution between 2011 and 2018. We identified eight patients who developed extensive SAA on follow-up...
June 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29883193/analgesic-effect-and-potential-cumulative-benefit-from-caudal-epidural-d5w-in-consecutive-participants-with-chronic-low-back-and-buttock-leg-pain
#2
Liza Maniquis-Smigel, Kenneth Dean Reeves, Howard Jeffrey Rosen, John Lyftogt, Cassie Graham-Coleman, An-Lin Cheng, David Rabago
OBJECTIVES: Chronic low-back pain (CLBP) participants in a prior controlled study reported short-term pain relief after caudal epidural injection of 5% dextrose (D5W). This study assessed whether repeated caudal epidural injections of D5W results in serial short-term diminution of CLBP and progressive long-term decrease in pain and disability. DESIGN: Prospective uncontrolled study. SETTINGS/LOCATION: Outpatient pain clinic. SUBJECTS: Adults with CLBP with radiation to gluteal or leg areas...
June 8, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29882012/the-preliminary-results-of-a-new-ct-guided-periradicular-cervical-steroid-injection-technique-safety-and-feasibility-of-the-lateral-peri-isthmic-approach-in-28-patients
#3
Onur Levent Ulusoy, Deniz Alis, Ayhan Mutlu, Bulent Colakoglu, Mustafa Sirvanci
BACKGROUND: Computed tomography (CT)-guided cervical nerve injections are broadly being used in the treatment of cervical radiculopathy; however, catastrophic complications have been reported. Herein, we aimed to evaluate the efficacy, feasibility, and safety of a novel CT-guided cervical injection technique. MATERIALS AND METHODS: We prospectively performed cervical injections in 28 patients with cervical radiculopathies using a novel CT-guided cervical transforaminal injection technique; lateral peri-isthmic approach in which the tip of the needle advanced to the lateral cortex of the isthmus instead of the foraminal area...
June 7, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29871385/in-response-to-huhn-et-al-re-hypothalamic-pituitary-adrenocortical-axis-suppression-following-a-single-epidural-injection-of-methylprednisolone-acetate-review-patient-safety-and-clinical-care
#4
https://www.readbyqxmd.com/read/29871371/comparison-of-epidural-spreading-patterns-and-clinical-outcomes-of-transforaminal-epidural-steroid-injection-with-high-volume-injectate-via-the-subpedicular-versus-the-retrodiscal-approach
#5
Won-Joong Kim, Hwa-Yong Shin, Seung Hee Yoo, Hahck Soo Park
BACKGROUND: The effect of transforaminal epidural steroid injection (TFESI) appears to be influenced by the volume of the injected material because there is a positive correlation between injection volume and extent of pain relief. OBJECTIVES: The purpose of this study was to examine how many vertebral segments are covered by the subpedicular (SP) approach and the retrodiscal (RD) approach and to compare the clinical outcomes of the 2 approaches in TFESI with high-volume injectates...
May 2018: Pain Physician
https://www.readbyqxmd.com/read/29871368/effect-of-different-volumes-on-pain-relief-in-patient-receiving-fluoroscopic-guided-interlaminar-lumbar-epidural-steroid-injection
#6
Jeetinder Kaur Makkar, Balbir Kumar, Kajal Jain, Saravdeep S Dhutt, Y K Batra, Preet Mohinder Singh
BACKGROUND: Epidural steroids injections (ESI) are frequently used to treat lumbar radicular pain. Although different volume have been used for interlaminar ESI in adults, there is no controlled trial comparing the effect of different volumes on pain relief for the same dose of steroid . OBJECTIVE: To compare the effect of increase in volume of epidural drug on pain relief in lumbar ESI. STUDY DESIGN: Randomized double blind trial SETTING: Pain OR of a tertiary care centre METHODS: Sixty patients were randomly allocated to 1 of 3 groups: Group A (4 mL), Group B (6 mL), and Group C (8 mL)...
May 2018: Pain Physician
https://www.readbyqxmd.com/read/29870446/lumbar-epidural-corticosteroid-injection-reduces-subacute-pain-and-improves-knee-function-in-the-first-six-weeks-after-total-knee-arthroplasty-a-double-blinded-randomized-trial
#7
Nattapol Tammachote, Alisa Seangleulur, Supakit Kanitnate
BACKGROUND: Pain control immediately following total knee arthroplasty (TKA) has been a focus for orthopaedists. However, control of subacute pain, which may persist up to 3 months, is usually not optimized. The efficacy of epidural corticosteroids in reducing pain after surgery is documented, but data on their efficacy in controlling subacute pain after TKA are lacking. Our aim was to investigate the efficacy of an epidural corticosteroid in controlling pain in the first 3 months following TKA using a double-blinded randomized clinical trial...
June 6, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29812982/ct-fluoroscopy-guided-interlaminar-epidural-steroid-injections-in-the-cervical-spine-rate-of-nontarget-injection-into-the-retrodural-space-of-okada
#8
Sherveen N Parivash, Peter G Kranz, Linda Gray, Timothy J Amrhein
OBJECTIVE: The purpose of this study was to assess the rate of inadvertent injection into the retrodural space of Okada during CT fluoroscopy-guided interlaminar epidural steroid injection in the cervical spine. MATERIALS AND METHODS: Images from cases of cervical interlaminar epidural steroid injection under CT fluoroscopic guidance performed at a single institution between November 2009 and November 2015 were obtained and reviewed. For all cases, the following information was recorded: presence or absence of contrast material within the Okada space, cervical anatomic level at which the procedure was performed, laterality of approach, trainee presence, and years of proceduralist experience...
May 29, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29800710/induced-lumbosacral-radicular-symptom-referral-patterns-a-descriptive-study
#9
Michael B Furman, Stephen C Johnson
BACKGROUND CONTEXT: Lumbosacral radicular symptoms are commonly evaluated in clinical practice. Level specific diagnosis is crucial for management. Clinical decisions are often made by correlating a patient's symptom distribution and imaging with sensory dermatomal maps. It is not uncommon for patients to describe non-dermatomal symptom patterns or for imaging to demonstrate pathology at levels not predicted by a dermatomal map. These observations suggest that the referred symptom distribution from lumbosacral nerve root provocation is different from dermatomal maps...
May 22, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29800245/critically-evaluating-the-evidence-for-epidural-injections-for-failed-back-surgery-syndrome-should-pain-physicians-be-bracing-for-impact
#10
David E Jamison, Steven P Cohen
No abstract text is available yet for this article.
May 24, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29794943/erector-spinae-plane-block-versus-retrolaminar-block-a-magnetic-resonance-imaging-and-anatomical-study
#11
Sanjib Das Adhikary, Stephanie Bernard, Hector Lopez, Ki Jinn Chin
BACKGROUND AND OBJECTIVES: The erector spinae plane (ESP) and retrolaminar blocks are ultrasound-guided techniques for thoracoabdominal wall analgesia involving injection into the musculofascial plane between the paraspinal back muscles and underlying thoracic vertebrae. The ESP block targets the tips of the transverse processes, whereas the retrolaminar block targets the laminae. We investigated if there were differences in injectate spread between the 2 techniques that would have implications for their clinical effect...
May 23, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29781504/epidural-versus-non-epidural-or-no-analgesia-for-pain-management-in-labour
#12
REVIEW
Millicent Anim-Somuah, Rebecca Md Smyth, Allan M Cyna, Anna Cuthbert
BACKGROUND: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. OBJECTIVES: To assess the effectiveness and safety of all types of epidural analgesia, including combined-spinal-epidural (CSE) on the mother and the baby, when compared with non-epidural or no pain relief during labour...
May 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29770432/automated-mandatory-bolus-versus-basal-infusion-for-maintenance-of-epidural-analgesia-in-labour
#13
REVIEW
Ban Leong Sng, Yanzhi Zeng, Nurun Nisa A de Souza, Wan Ling Leong, Ting Ting Oh, Fahad Javaid Siddiqui, Pryseley N Assam, Nian-Lin R Han, Edwin Sy Chan, Alex T Sia
BACKGROUND: Childbirth may cause the most severe pain some women experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour and is considered to be the reference standard. Traditionally epidural analgesia has been delivered as a continuous infusion via a catheter in the epidural space, with or without the ability for the patient to supplement the analgesia received by activating a programmable pump to deliver additional top-up doses, known as patient-controlled epidural analgesia (PCEA)...
May 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29768371/complex-regional-pain-syndrome-type-ii-after-cervical-transforaminal-epidural-injection-a-case-report
#14
Gi-Young Park, Dong Rak Kwon, Dae Gil Kwon
RATIONALE: We report a case of a 61-year-old patient who developed complex regional pain syndrome (CRPS) type II after a cervical transforaminal epidural steroid injection (CTESI). PATIENT CONCERNS: The patient developed sudden-onset severe pain and swelling of his upper right limb after a cervical transforaminal epidural injection. DIAGNOSES: On physical examination, the patient's symptoms and signs corresponded to the Budapest criteria for CRPS...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29762288/in-lumbar-spinal-stenosis-adding-corticosteroids-to-lidocaine-epidural-injections-did-not-improve-pain-or-function-at-12-months
#15
Nitin B Jain, Byron Schneider
No abstract text is available yet for this article.
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29756696/preliminary-experience-with-epidural-and-perineural-catheter-localization-with-pulsed-wave-doppler-ultrasonography
#16
Hesham Elsharkawy, Theresa Barnes, Rovnat Babazade, Maria Huarte, Wael Ali Sakr Esa, Brian M Ilfeld
BACKGROUND: Various methods for peripheral nerve and epidural catheter location assessment exist, with varying degrees of ease of use, utility, and accuracy. Pulsed wave Doppler (PWD) evaluates the presence of fluid flow and is possible modality to assess the location of a percutaneously inserted perineural catheter. METHODS: A retrospective chart review was conducted in which PWD ultrasonography was used to confirm the position of nerve catheters for regional anesthesia...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29756333/safe-use-of-epidural-corticosteroid-injections-recommendations-of-the-wip-benelux-workgroup
#17
REVIEW
Koen Van Boxem, Mienke Rijsdijk, Guy Hans, Jasper de Jong, Jan Willem Kallewaard, Kris Vissers, Maarten van Kleef, James P Rathmell, Jan Van Zundert
BACKGROUND: Epidural corticosteroid injections are used frequently worldwide in the treatment of radicular pain. Concerns have risen involving rare major neurologic injuries after this treatment. Recommendations to prevent these complications have been published, but local implementation is not always feasible due to local circumstances and necessitating local recommendations based on literature review. METHODS: A workgroup of 4 stakeholder pain societies in Belgium, The Netherlands and Luxembourg (Benelux) has reviewed the literature involving neurological complications after epidural corticosteroid injections and possible safety measures to prevent these major neurologic injuries...
May 14, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29755622/serum-triamcinolone-levels-following-cervical-interlaminar-epidural-injection
#18
Tim J Lamer, Rozalin R Dickson, Halena M Gazelka, Wayne T Nicholson, Joel M Reid, Susan M Moeschler, W Michael Hooten
Background: Cervical interlaminar epidural steroid injections (ESIs) are commonly performed procedures to treat painful cervical radiculopathy, but little is known about the systemic absorption and serum levels of steroids following injection. The primary objective of this study was to investigate the pharmacokinetics of fluoroscopy-guided cervical epidural-administered triamcinolone acetonide in a cohort of patients with cervical radicular pain seeking treatment in a pain medicine clinic...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/29753830/objective-technical-considerations-for-appropriate-digital-subtraction-imaging-during-cervical-transforaminal-epidural-steroid-injection
#19
Zachary L McCormick, Vinil N Shah
No abstract text is available yet for this article.
May 10, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29751191/can-epidural-contrast-dispersal-pattern-help-to-predict-the-outcome-of-transforaminal-epidural-steroid-injections-in-patients-with-lumbar-radicular-pain
#20
M D Duygu Tecer, Emre Adiguzel, Ozlem Koroglu, Arif K Tan, Mehmet A Taskaynatan
BACKGROUND: To investigate the relationship between epidurographic contrast dispersal patterns and both immediate and short term clinical effectiveness of lumbar transforaminal epidural steroid injections (TFESIs) in patients with radicular back pain. METHODS: Digital database of 64 patients who underwent single-level lumbar TFESI for unilateral lumbar radicular pain were scanned Type of contrast pattern was analyzed by 1 physiatrist and definied as follows: type I (tubular appearance); type II (nerve root visible as a filling defect); or type III (cloudlike appearance)...
May 8, 2018: World Neurosurgery
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