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Transforaminal injection

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https://www.readbyqxmd.com/read/28229033/an-innovative-use-of-cortoss-bone-cement-to-stabilize-a-nonunion-after-interbody-fusion
#1
Michelle Granville, Robert E Jacobson
A 65-year-old male originally had surgery for spondylolisthesis at L5-S1 in 2008 and then went on to have an L4-5 transforaminal lumbar interbody fusion (TLIF) with pedicle screw fixation from L4 to S1 and interbody graft in 2010. Despite having two surgical procedures, he continued with intractable back pain and was told he had a failed lumbar fusion. When he was evaluated with a computerized tomography (CT) scan from April 2015, it demonstrated an erosive nonunion of the L4-5 interbody fusion without incorporation of the polyetheretherketone (PEEK) cage...
January 20, 2017: Curēus
https://www.readbyqxmd.com/read/28209578/intraforaminal-location-of-thoracolumbar-radicular-arteries-providing-an-anterior-radiculomedullary-artery-using-flat-panel-catheter-angiotomography
#2
L Gregg, D E Sorte, P Gailloud
BACKGROUND AND PURPOSE: Flat panel catheter angiotomography performed during the selective injection of intersegmental arteries offers a multiplanar assessment of the intraforaminal course of the radicular arteries providing an anterior radiculomedullary artery. Injury of anterior radiculomedullary arteries during transforaminal epidural steroid injections can result in spinal cord damage. Evaluations of the intraforaminal location of these arteries have so far been limited to anteroposterior views or the examination of cadaveric material...
February 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28207664/descriptive-analysis-of-spinal-neuroaxial-injections-surgical-interventions-and-physical-therapy-utilization-for-degenerative-lumbar-spondylolisthesis-within-medicare-beneficiaries-from-2000-to-2011
#3
Joseph A Sclafani, Alexandra Constantin, Pei-Shu Ho, Venu Akuthota, Leighton Chan
STUDY DESIGN: A retrospective, observational study. OBJECTIVE: The aim of this study was to determine the utilization of various treatment modalities in the management of degenerative spondylolisthesis within Medicare beneficiaries. SUMMARY OF BACKGROUND DATA: Degenerative lumbar spondylolisthesis is a condition often identified in symptomatic low back pain. A variety of treatment algorithms including physical therapy and interventional techniques can be used to manage clinically significant degenerative spondylolisthesis...
15, 2017: Spine
https://www.readbyqxmd.com/read/28203184/spinal-cord-infarction-after-cervical-transforaminal-epidural-steroid-injection-case-report-and-literature-review
#4
Jangsup Moon, Hyung-Min Kwon
INTRODUCTION: Transforaminal epidural steroid injection (TFESI) is a widely used nonsurgical procedure in the treatment of patients with radiculopathy. It is efficacious in relieving pain, but a number of complications are being reported. Recently, increasing frequency of major complications, such as spinal cord infarction and cerebral infarction, has been reported with the use of a particulate steroid within fluoroscopic-guided procedures. METHODS: We report a 49-year-old man with a history of chronic cervical radiculopathy, who experienced a devastating complication after TFESI...
January 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28192271/ventral-spontaneous-durotomy-following-vaginal-delivery
#5
Nitin Agarwal, Ahmed I Kashkoush, Arpan V Prabhu, Raymond F Sekula
INTRODUCTION: Dural breaches have a diverse etiology, including spontaneous rupture and trauma. Most cases resolve with bedrest, though in refractory cases an epidural blood patch can be placed to obstruct further leakage. Here, we discuss a unique case of a spontaneous ventral durotomy following vaginal delivery managed with injections of autologous blood through bilateral transforaminal needles. CLINICAL PRESENTATION: A previously healthy 36-year-old pregnant female presented to the inpatient maternity ward with positional occipital headaches and neck pain 24 hours following normal spontaneous vaginal delivery...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28168618/the-short-and-midterm-outcomes-of-lumbar-transforaminal-epidural-injection-with-preganglionic-and-postganglionic-approach-in-lumbosacral-radiculopathy-a-systematic-review-and-meta-analysis
#6
REVIEW
Saran Pairuchvej, Alisara Arirachakaran, Gun Keorochana, Komkrich Wattanapaiboon, Surapon Atiprayoon, Phoonyathorn Phatthanathitikarn, Jatupon Kongtharvonskul
The purpose of this study was to compare clinical outcomes after preganglionic versus ganglionic epidural steroid injection (ESI) using a systematic review and network meta-analysis. A systematic review and meta-regression was performed to compare postoperative outcomes between the two difference injection techniques. Relevant randomized controlled trials were identified from Medline and Scopus up to September 24, 2016. Sixteen out of 598 studies were eligible; 3, 2, and 3 studies were included in the pooling of outcomes including effectiveness, visual analog score (VAS), and complications (nerve root, injury, dural puncture, and intraneural injection)...
February 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28119838/the-prognostic-value-of-enhanced-mri-and-fluoroscopic-factors-for-predicting-the-effects-of-transforaminal-steroid-injections-on-lumbosacral-radiating-pain
#7
Yun Suk Jung, Jee Hyun Suh, Ha Young Kim, Kyunghoon Min, Yoongul Oh, Donghwi Park, Ju Seok Ryu
OBJECTIVE: To investigate the predictive value of enhanced-magnetic resonance imaging (MRI) and fluoroscopic factors regarding the effects of transforaminal epidural steroid injections (TFESIs) in low back pain (LBP) patients with lumbosacral radiating pain. METHODS: A total of 51 patients who had LBP with radiating pain were recruited between January 2011 and December 2012. The patient data were classified into the two groups 'favorable group' and 'non-favorable group' after 2 weeks of follow-up results...
December 2016: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28118274/radiopaque-line-in-front-of-the-lumbar-spine-during-a-s1-transforaminal-epidural-injection-where-is-the-contrast
#8
Osman Hakan Gunduz, Tulay Ercalik, Mehmet Cetin Baskaya
No abstract text is available yet for this article.
January 23, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28097241/extraforaminal-needle-tip-position-reduces-risk-of-intravascular-injection-in-ct-fluoroscopic-lumbar-transforaminal-epidural-steroid-injections
#9
Robinson K Yu, Gerritt M Lagemann, Anish Ghodadra, Vikas Agarwal
BACKGROUND: Lumbar transforaminal epidural steroid injection is a common and effective tool for managing lumbar radicular pain, although accidental intravascular injection can rarely result in paralysis. The purpose of this study is to determine the safest needle tip position for computed tomography (CT)-guided lumbar transforaminal epidural steroid injections as determined by incidence of intravascular injection. METHODS: Three radiologists, in consensus, reviewed procedural imaging for consecutive CT-fluoroscopic lumbar transforaminal epidural steroid injections performed during a 16-month period...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28094428/intra-operative-results-and-post-operative-clinical-outcomes-of-lumbar-microdiscectomy-in-patients-received-transforaminal-anterior-epidural-steroid-injection-earlier-for-lumbar-radiculopathy
#10
Sait Ozturk, Bekir Akgun, Fatih Serhat Erol, Selami Ates Onal, Metin Kaplan
AIM: We have aimed to describe the intra and postoperative results of patients who received transforaminal anterior epidural steroid injection (TAESI) prior to undergoing lumbar microdiscectomy. MATERIAL AND METHODS: 64 of 2461 patients evaluated who had received minimally invasive technique (MIT) for lumbar radiculopathy and who felt no relief after the procedures. 32 patients of them treated with different techniques other than TAESI and those receiving thrombolytic or anticoagulant drugs before microdiscectomy were excluded...
December 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28093372/does-trainee-involvement-in-fluoroscopic-injections-affect-fluoroscopic-time-immediate-pain-reduction-and-complication%C3%A2-rate
#11
Daniel Cushman, Masaru Teramoto, Bradley Curtis, David T Lee, Austin Marcolina, Zachary McCormick
BACKGROUND: Patients have expressed concern about undergoing procedures involving trainees, even with direct attending physician supervision. Little literature has examined the effect of trainee involvement on patient outcomes. OBJECTIVE: We aimed to evaluate the effect of trainee involvement on patient complications, immediate pain reduction, and fluoroscopic time for different fluoroscopic injection types. DESIGN: Retrospective review. SETTING: Four academic outpatient institutions with Accreditation Council for Graduate Medical Education (ACGME)-accredited residency (physical medicine and rehabilitation, or anesthesiology) or fellowship (sports medicine or pain medicine) programs from 2000 to 2015...
January 16, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28072802/efficacy-of-adjuvant-10-hypertonic-saline-in-transforaminal-epidural-steroid-injection-a-retrospective-analysis
#12
Eun Young Joo, Won Uk Koh, Seong-Soo Choi, Jae-Hyung Choi, Ho-Soo Ahn, Hye Joo Yun, Jin-Woo Shin
BACKGROUND: Chronic lower back pain with or without radiculopathy represents an important medical, social, and economic problem. Many treatment modalities and techniques, including surgery and epidural administration of steroids, have been used to manage this pain. Hypertonic saline, which has been used as an adjunct to percutaneous epidural adhesiolysis, can also be injected via a transforaminal approach in expectation of longer-lasting effects. OBJECTIVES: This study aimed to determine the effect of adding hypertonic saline to conventional transforaminal epidural steroid injections (TFEI) to provide pain relief for chronic radiculopathy patients...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28025353/imaging-determinants-of-clinical-effectiveness-of-lumbar-transforaminal-epidural-steroid-injections
#13
Timothy P Maus, Christine A El-Yahchouchi, Jennifer R Geske, Rickey E Carter, Timothy J Kaufmann, John T Wald, Felix E Diehn
OBJECTIVE: To examine associations between imaging characteristics of compressive lesions and patient outcomes after lumbar transforaminal epidural steroid injections (TFESIs) stratified by steroid formulation (solution versus suspension). DESIGN/SUBJECTS: Retrospective observational study, academic radiology practice. A 516-patient sample was selected from 2,634 consecutive patients receiving lumbar TFESI for radicular pain. METHODS: The advanced imaging study(s) preceding sampled TFESI were reviewed...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28025351/immediate-adverse-events-in-interventional-pain-procedures-a-multi-institutional-study
#14
Carrie M Carr, Christopher T Plastaras, Matthew J Pingree, Matthew Smuck, Timothy P Maus, Jennifer R Geske, Christine A El-Yahchouchi, Zachary L McCormick, David J Kennedy
SETTING: Interventional procedures directed toward sources of pain in the axial and appendicular musculoskeletal system are performed with increasing frequency. Despite the presence of evidence-based guidelines for such procedures, there are wide variations in practice. Case reports of serious complications such as spinal cord infarction or infection from spine injections lack appropriate context and create a misleading view of the risks of appropriately performed interventional pain procedures...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28017166/comparison-of-transforaminal-and-interlaminar-epidural-steroid-injections-for-the-treatment-of-chronic-lumbar-pain
#15
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...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27965254/retrospective-cohort-study-of-usage-patterns-of-epidural-injections-for-spinal-pain-in-the-us-fee-for-service-medicare-population-from-2000-to-2014
#16
Laxmaiah Manchikanti, Vidyasagar Pampati, Joshua A Hirsch
OBJECTIVE: To assess the usage patterns of epidural injections for chronic spinal pain in the fee-for-service (FFS) Medicare population from 2000 to 2014 in the USA. DESIGN: A retrospective cohort. METHODS: The descriptive analysis of the administrative database from Centers for Medicare and Medicaid Services (CMS) Physician/Supplier Procedure Summary (PSPS) master data from 2000 to 2014 was performed. The guidance from Strengthening the Reporting of Observational studies in Epidemiology (STROBE) was applied...
December 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27935769/fluoroscopically-guided-epidural-injections-of-the-cervical-and-lumbar-spine
#17
Euddeum Shim, Joon Woo Lee, Eugene Lee, Joong Mo Ahn, Yusuhn Kang, Heung Sik Kang
Advances in imaging and the development of injection techniques have enabled spinal intervention to become an important tool in managing chronic spinal pain. Epidural steroid injection (ESI) is one of the most widely used spinal interventions; it directly delivers drugs into the epidural space to relieve pain originating from degenerative spine disorders-central canal stenoses and neural foraminal stenoses-or disk herniations. Knowledge of the normal anatomy of the epidural space is essential to perform an effective and safe ESI and to recognize possible complications...
December 9, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27915069/systematic-review-of-the-efficacy-of-particulate-versus-nonparticulate-corticosteroids-in-epidural-injections
#18
REVIEW
Priyesh Mehta, Isaac Syrop, Jaspal Ricky Singh, Jonathan Kirschner
OBJECTIVE: To systematically analyze published studies in regard to the comparative efficacy of particulate versus nonparticulate corticosteroids for cervical and lumbosacral epidural steroid injections (ESI) in reducing pain and improving function. TYPE: Systematic review. LITERATURE SURVEY: MEDLINE (Ovid), EMBASE, and Cochrane databases were searched from the period of 1950 to December 2015. METHODOLOGY: Criteria for inclusion in this review were (1) randomized controlled trials and (2) retrospective studies that compared particulate versus nonparticulate medication in fluoroscopically guided injections via a transforaminal (TF) or interlaminar (IL) approach...
November 30, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27906952/conus-medullaris-infarction-after-a-right-l4-transforaminal-epidural-steroid-injection-using-dexamethasone
#19
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/27898479/the-effect-of-skin-pressure-on-needle-entry-point-accuracy-during-fluoroscopically-guided-lumbar-transforaminal-epidural-injections-a-randomized-clinical-trial
#20
Soon Young Yun, Duck Mi Yoon, Kyung Bong Yoon, Ji Ae Moon, Shin Hyung Kim
OBJECTIVE: The aim of this study was to investigate the effect of skin pressure on needle entry point accuracy during fluoroscopically guided lumbar transforaminal epidural injection. DESIGN: This study is a prospective randomized clinical trial; 64 patients with a body mass index of 25 kg/m or greater were enrolled. For patients in the pressing group, the operator marked the needle entry point on the patient's back while pressing the patient's skin with the tip of an indicator...
February 2017: American Journal of Physical Medicine & Rehabilitation
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