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Epidural steroid

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https://www.readbyqxmd.com/read/28726118/epidural-steroid-injection-related-events-requiring-hospitalisation-or-emergency-room-visits-among-52-935-procedures-performed-at-a-single-centre
#1
Joon Woo Lee, Eugene Lee, Guen Young Lee, Yusuhn Kang, Joong Mo Ahn, Heung Sik Kang
OBJECTIVES: To analyse the incidence and type of epidural steroid injection (ESI)-related adverse events, including procedure-related complications and drug-related systemic effects requiring hospitalisation or emergency room (ER) visits. METHODS: This study included 52,935 ESI procedures performed in 22,059 patients in our department from March 2004 to February 2016. Of these, we retrospectively reviewed the cases of 1570 patients (1713 procedures) who were hospitalised or visited the ER within 1 month after ESI...
July 19, 2017: European Radiology
https://www.readbyqxmd.com/read/28720990/selective-nerve-root-blocks-vs-caudal-epidural-injection-for-single-level-prolapsed-lumbar-intervertebral-disc-a-prospective-randomized-study
#2
Sudhir Singh, Sanjiv Kumar, Gaurav Chahal, Reetu Verma
BACKGROUND: Chronic lumbar radiculopathy has a lifetime prevalence of 5.3% in men and 3.7% in women. It usually resolves spontaneously, but up to 30% cases will have pronounced symptoms even after one year. AIMS: A prospective randomized single-blind study was conducted to compare the efficacy of caudal epidural steroid injection and selective nerve root block in management of pain and disability in cases of lumbar disc herniation. METHODS: Eighty patients with confirmed single-level lumbar disc herniation were equally divided in two groups: (a) caudal epidural and (b) selective nerve root block group, by a computer-generated random allocation method...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28710985/spinal-cord-compression-secondary-to-idiopathic-thoracic-epidural-lipomatosis-in-an-adolescent-a-case-report-and-review-of-literature
#3
Rumaiza Al-Yafeai, Yazid Maghrabi, Hussein Malibary, Saleh Baeesa
INTRODUCTION: Spinal epidural lipomatosis (SEL) is a rare condition that presents with progressive spinal cord or nerve root compression. It is commonly reported in patients receiving long-term exogenous steroid therapy or in patients with endogenous steroid overproduction. The occurrence of this condition as an idiopathic entity is rarely reported. CASE PRESENTATION: The authors present the clinical course and outcome of a 16-year-old male student, who presented with progressive spastic paraparesis of a one-year duration caused by idiopathic spinal epidural lipomatosis...
July 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28704909/tophaceous-gout-in-the-lumbar-spinal-canal-mimicking-epidural-spinal-tumor
#4
Taeshin Kim, Bum-Joon Kim, Se-Hoon Kim, Seung-Hwan Lee
Gout is an inflammatory arthritis characterized by deposition of monosodium urate crystals in joints. Though gout frequently involves the big toe or other extremities, it rarely occurs in the spinal canal. A 35-year-old man presented with left L5 radiculopathy. He had leg pain for 8 months and received several epidural steroid injections. Magnetic resonance imaging revealed a 1.7×1.1-cm ovoid contrast-enhancing mass, causing pressure erosion of the left L5 pedicle. Microscopic laminotomy was performed at the left L5 lamina...
June 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28696946/optimal-treatment-for-lumbar-spinal-stenosis-an-update
#5
Janus Patel, Ian Osburn, Anne Wanaselja, Ryan Nobles
PURPOSE OF REVIEW: Our review of current literature within the past 12-24 months for the treatment of lumbar spinals stenosis (LSS) serves to update providers on recent advances and comparisons regarding therapy spanning lifestyle modification, pharmacologic therapy, minimally invasive interventions, and surgical interventions. RECENT FINDINGS: Current literature supporting the inclusion of physical therapy and gabapentin/pregabalin within an initial treatment regimen have been positive...
July 10, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28681962/systematic-review-of-management-of-chronic-pain-after-surgery
#6
REVIEW
V Wylde, J Dennis, A D Beswick, J Bruce, C Eccleston, N Howells, T J Peters, R Gooberman-Hill
BACKGROUND: Pain present for at least 3 months after a surgical procedure is considered chronic postsurgical pain (CPSP) and affects 10-50 per cent of patients. Interventions for CPSP may focus on the underlying condition that indicated surgery, the aetiology of new-onset pain or be multifactorial in recognition of the diverse causes of this pain. The aim of this systematic review was to identify RCTs of interventions for the management of CPSP, and synthesize data across treatment type to estimate their effectiveness and safety...
July 6, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28667547/transversus-abdominis-plane-tap-block-versus-thoracic-epidural-analgesia-tea-in-laparoscopic-colon-surgery-in-the-eras-program
#7
Basilio Pirrera, Vincenzo Alagna, Andrea Lucchi, Pierluigi Berti, Carlo Gabbianelli, Giacomo Martorelli, Lorella Mozzoni, Federico Ruggeri, Alessandro Ingardia, Giuseppe Nardi, Gianluca Garulli
AIM: The enhanced recovery after surgery (ERAS) pathway and laparoscopic approach had been proven beneficial for patients and should now be considered as a standard of care in colorectal surgery. Multimodal analgesia is the gold standard in the ERAS program with the use of thoracic epidural analgesia (TEA). Few data are available on Transversus abdominis plane (TAP) blocks in laparoscopic colorectal surgery and ERAS pathway. The aim of this study is to evaluate the efficacy of TAP block compared to TEA in the management of postoperative pain and the impact on the recurrence of postoperative nausea, vomiting and ileus in laparoscopic colorectal surgery in the ERAS program...
July 1, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28663652/clonidine-as-an-adjuvant-in-fluoroscopic-guided-transforaminal-epidural-steroid-injection-in-a-patient-of-chronic-lumbosacral-radiculopathy
#8
Nandita Mehta, Misbah Salaria, A Q Salaria
Transforaminal epidural steroid injection (TFESI) is a minimally invasive modality used to treat patients with lumbosacral radiculopathy secondary to prolapsed intervertebral disc or spinal canal stenosis. In this case report, we describe the management of a patient with chronic lumbosacral radiculopathy secondary to intervertebral disc herniation which was seen as a right paracentral disc protrusion at levels L4-L5, L5-S1 causing thecal sac indentation, effacement of the right lateral recess and right exiting nerve root impingement as was seen on the magnetic resonance image...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28614233/discordant-lumbar-epidural-hematoma-after-caudal-steroid-injection-a-case-report-care-compliant
#9
Jung Ju Choi, Young Jin Chang, Wol Seon Jung, Kyung Cheon Lee, Ju Ho Kim, Youn Yi Jo
RATIONALE: Caudal epidural injection is one of the conventional treatments of chronic back pain. Even though spinal epidural hematoma after caudal epidural injection is rare but it can cause serious neurologic complication. PATIENT CONCERNS: An 83-year-old woman taking cilostazol received caudal epidural steroid injection because of her chronic back pain. Six hours later, she experienced an acute hip pain which worsened with time. DIAGNOSIS: Magnetic resonance image showed acute cord compression due to a spinal epidural hematoma at L2-S1 level with concomitant central canal compromise at L2/3, L3/4 level...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28605800/fact-finders-for-patient-safety-routine-intravenous-access-for-epidural-steroid-injections-without-sedation
#10
Zachary L McCormick, Adrian Popescu, Clark C Smith
No abstract text is available yet for this article.
June 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28605794/subdural-extra-arachnoid-flow-pattern-visualized-in-a-contralateral-oblique-view-during-a-cervical-interlaminar-epidural-steroid-injection
#11
David Levi
No abstract text is available yet for this article.
June 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28591865/reliability-and-accuracy-of-mri-laminar-angle-measurements-to-determine-intraprocedural-contralateral-oblique-view-angle-for-cervical-or-thoracic-interlaminar-epidural-steroid-injections-safety-before-accuracy
#12
Jatinder Gill, Thomas Simopoulos
No abstract text is available yet for this article.
June 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28575334/characterization-of-peripheral-and-central-sensitization-after-dorsal-root-ganglion-intervention-in-patients-with-unilateral-lumbosacral-radicular-pain-a-prospective-pilot-study
#13
V Mehta, S Snidvongs, B Ghai, R Langford, T Wodehouse
Background.: Quantitative sensory testing (QST) has been used to predict the outcome of epidural steroid injections in lumbosacral radicular pain and has the potential to be an important tool in the selection of appropriate treatment (such as epidural steroid injections vs surgery) for patients with chronic radicular pain. In addition, QST assists in identification of the pain pathways of peripheral and central sensitization in selected groups of patients. Methods.: Twenty-three patients were given dorsal root ganglion (DRG) infiltration with local anaesthesia and steroid ('DRG block'), and those who demonstrated at least 50% pain relief were offered pulsed radiofrequency (PRF) to the DRG...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28553170/new-optimal-needle-entry-angle-for-cervical-transforaminal-epidural-steroid-injections-a-retrospective-study
#14
Myong-Hwan Karm, Jun Young Park, Doo Hwan Kim, Hyun-Seok Cho, Jae-Young Lee, Koo Kwon, Jeong Hun Suh
Objective: A cervical epidural steroid injection is one of the most commonly performed interventions to manage chronic neck pain and cervical radiculopathy. Despite its many severe complications, cervical transforaminal epidural steroid injection (CTFESI) is a clinically necessary modality for managing neck pain and cervical radiculopathy. We aimed in this study to find a safer optimal needle entry angle to decrease the chance of an accidental vertebral artery (VA) puncture even with a proper needle entry angle and to visualize the target of the needle tip...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28545491/treatment-of-acute-sciatica-with-transforaminal-epidural-corticosteroids-and-local-anesthetic-design-of-a-randomized-controlled-trial
#15
Bastiaan C Ter Meulen, Esther T Maas, Amrita Vyas, Marinus van der Vegt, Koo de Priester, Michiel R de Boer, Maurits W van Tulder, Henry C Weinstein, Raymond W J G Ostelo
BACKGROUND: Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. METHODS: We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica...
May 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28542102/influence-of-paravertebral-muscle-quality-on-treatment-efficacy-of-epidural-steroid-infiltration-or-surgical-decompression-in-lumbar-spinal-stenosis-analysis-of-the-lumbar-spinal-outcome-study-lsos-data-a-swiss-prospective-multi-center-cohort-study
#16
Michael Betz, Jakob M Burgstaller, Ulrike Held, Gustav Andreisek, Johann Steurer, Francois Porchet, Mazda Farshad
STUDY DESIGN: Prospective multi-center cohort study. OBJECTIVE: To study the question whether paravertebral muscle quality may affect the clinical outcome of epidural steroid infiltration (ESI) or surgical decompression in patients with symptomatic lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: To the present, the impact of paravertebral muscle quality on clinical outcome of epidural steroid infiltration (ESI) or surgical decompression in patients with lumbar spinal stenosis (LSS) has not been clarified...
May 25, 2017: Spine
https://www.readbyqxmd.com/read/28540126/neurological-complications-of-lumbar-and-cervical-dural-punctures-with-a-focus-on-epidural-injections
#17
Nancy E Epstein
BACKGROUND: Various types of lumbar dural punctures may contribute to neurological injury. The etiologies of dural injury include; inadvertent dural punctures due to epidurals placed for labor anesthesia, epidural steroid injections (ESI/transforaminal TESI; approximately 9 million ESI performed in the US per year), deliberate placement of intradural pain devices, and spontaneous cerebrospinal fluid (CSF) fistulas. Resulting neurological complications may include; spinal headaches/intracranial hypotension, subdural hematomas, and 6(th) nerve cranial palsies...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28540118/spinal-cord-injury-in-the-geriatric-population-risk-factors-treatment-options-and-long-term-management
#18
REVIEW
Tochukwu C Ikpeze, Addisu Mesfin
Spinal cord injuries (SCIs) are sustained by more than 12 500 patients per year in the United States and more globally. The SCIs disproportionately affect the elderly, especially men. Approximately 60% of these injuries are sustained traumatically through falls, but nontraumatic causes including infections, tumors, and medication-related epidural bleeding have also been documented. Preexisting conditions such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis can render the spine stiff and are risk factors as well as cervical spondylosis and ensuing cervical stenosis...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28535567/radiation-dose-and-procedure-time-for-994-ct-guided-spine-pain-control-procedures
#19
Matthew S Lazarus, Rebecca B Forman, Alan L Brook, Todd S Miller
BACKGROUND: Image guidance for spine pain control procedures, including epidural steroid injection, nerve root block, and facet block, can be performed with either computed tomography (CT) or conventional fluoroscopy. CT has the advantage of improved anatomic localization and use of air for contrast; however, there are concerns that CT leads to higher radiation dose and longer procedure time. OBJECTIVE: To evaluate procedure time and radiation dose for multiple types of spine pain control procedures performed under CT guidance...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#20
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
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