keyword
https://read.qxmd.com/read/38037489/the-carbon-footprint-of-epidural-steroid-injections-a-pilot-study
#21
JOURNAL ARTICLE
Alexandra E Fogarty, Annalee Wilson, Maya Godambe, Nidhi Shinde, Christine Gou, Gregory Decker, Joe Steensma
INTRODUCTION: Epidural steroid injections are common procedures in PM&R practice. However, their environmental impact has not been characterized. OBJECTIVE: The primary aim is to estimate and compare the carbon footprint of two standard injection kits utilized to perform epidural steroid injections at a single academic institution. Secondary objectives were 1) to create a step-by-step guide for estimating the carbon footprint of materials and 2) to survey physicians on practice patterns and identify areas for improvement...
December 1, 2023: PM & R: the Journal of Injury, Function, and Rehabilitation
https://read.qxmd.com/read/38025825/interventional-therapy-and-surgical-management-of-lumbar-disc-herniation-in-spine-surgery-a-narrative-review
#22
JOURNAL ARTICLE
Bongseok Jung, Justin Han, Junho Song, Alex Ngan, David Essig, Rohit Verma
Significant advancements in lumbar disc herniation (LDH) management have been made in interventional pain therapy, operative therapy, peri-operative management, and cost analysis of various procedures. The present review aims to provide a concise narrative of all these topics, current trends, and possible future directions in the management of LDH. Interventional pain management using intradiscal injections often serves as a minimally invasive non-surgical approach. Surgical modalities vary, including traditional open laminectomy, microdiscectomy, endoscopic discectomy, tubular discectomy, percutaneous laser disc decompression, and transforaminal foraminotomy...
2023: Orthopedic Reviews
https://read.qxmd.com/read/38022188/the-kumar-technique-a-novel-and-effective-approach-to-transforaminal-epidural-steroid-injections
#23
JOURNAL ARTICLE
Caitlin M Gray, Colby Skinner, Terrie Vasilopoulos, Chamara Gunaratne, Jin Choi, Angela Fadil, Sanjeev Kumar
Background Transforaminal epidural steroid injections (TFESIs) are widely used as a minimally invasive treatment for lumbar radicular pain. This study presents an alternative approach for lumbar TFESI, the Kumar Technique, which utilizes a more lateral and inferior needle starting point to better align the trajectory of the needle with the neural foramen. We hypothesize the Kumar Technique will result in safer and more effective outcomes than the traditional approach to TFESI. This article was previously presented as a poster at the 2023 University of Florida College of Medicine Celebration of Research on February 27-28, 2023, and as an abstract and poster at the 2023 University of Florida Department of Anesthesiology Celebration of Research on March 29, 2023...
October 2023: Curēus
https://read.qxmd.com/read/38013601/response-to-ter-meulen-et-al-effect-of-transforaminal-epidural-corticosteroid-injections-in-acute-sciatica
#24
JOURNAL ARTICLE
Koen Van Boxem, Antal van der Gaag, Jan Van Zundert, Jan Willem Kallewaard
No abstract text is available yet for this article.
November 28, 2023: Clinical Journal of Pain
https://read.qxmd.com/read/37976484/assessment-of-radiation-exposure-with-mandatory-two-fluoroscopic-views-for-epidural-procedures
#25
JOURNAL ARTICLE
Laxmaiah Manchikanti, Rachana Pasupuleti, Vidyasagar Pampati, Mahendra R Sanapati, Joshua A Hirsch
BACKGROUND: Various regulations and practice patterns develop on the basis of Local Coverage Determination (LCD), which are variably perceived as guidelines and/or mandated polices/ regulations. LCDs developed in 2021 and effective since December 2021 mandated a minimum of 2 views for final needle placement with contrast injection which includes both anteroposterior (AP) and lateral or oblique view. Radiation safety has been a major concern for pain physicians and multiple tools have been developed to reduce radiation dose, along with improvement in technologies to limit radiation exposure while performing fluoroscopically guided interventional procedures, with implementation of principles of As Low As Reasonably Achievable (ALARA)...
November 2023: Pain Physician
https://read.qxmd.com/read/37976483/output-current-and-efficacy-of-pulsed-radiofrequency-of-the-lumbar-dorsal-root-ganglion-in-patients-with-lumbar-radiculopathy-a-prospective-double-blind-randomized-pilot-study
#26
RANDOMIZED CONTROLLED TRIAL
Jae Ni Jang, Soyoon Park, Ji-Hoon Park, Yumin Song, Young Uk Kim, Dong Seong Kim, Jeong Eun Sohn, Sukhee Park
BACKGROUND: Lumbar radicular pain (LRP) is a common but challenging clinical symptom. Pulsed radiofrequency (PRF), a neuromodulation technique that uses short pulses of radiofrequency current, is effective in treating various pain disorders. However, few studies have been conducted on the effects of PRF and its modifying parameters. OBJECTIVES: Our study aimed to determine the intraoperative parameters of PRF of the lumbar dorsal root ganglion (DRG) that are related to clinical effects in patients with LRP unresponsive to transforaminal epidural steroid injections (TFESI)...
November 2023: Pain Physician
https://read.qxmd.com/read/37973127/pro-con-debate-superior-versus-inferior-triangle-needle-placement-in-transforaminal-epidural-injections
#27
JOURNAL ARTICLE
Tina L Doshi, Alyson M Engle, Aaron J Przybysz, Ariana M Nelson
Although transforaminal epidural injections have long been used for radicular pain, there is no universal standard injection approach to the neural foramen. The intervertebral foramen and its surrounding structures comprise an anatomically sensitive area that includes bone and joint structures, the intervertebral disk, blood vessels (in particular, the radicular arteries), the epidural sheath, and the spinal nerve root. Given the relatively high risk of inadvertent injury or injection to these nearby structures, image guidance for transforaminal epidural steroid injections (TFESIs) is standard of care...
December 1, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37973126/preferred-insertion-site-for-transforaminal-epidural-steroid-injections-safe-triangle-or-kambin-s-triangle
#28
JOURNAL ARTICLE
Alison Stout, Imran M Omar, Honorio T Benzon
No abstract text is available yet for this article.
December 1, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37946336/comparison-of-efficacy-between-transforaminal-epidural-steroid-injection-technique-without-contrast-versus-with-contrast-in-lumbar-radiculopathy-a-prospective-longitudinal-cohort-study
#29
JOURNAL ARTICLE
Waroot Pholsawatchai, Park Manakul, Warisara Lertcheewanan, Koopong Siribumrungwoung, Thongchai Suntharapa, Rattalerk Arunakul
STUDY DESIGN: A prospective longitudinal cohort study. PURPOSE: To evaluate the efficacy of two different techniques of transforaminal epidural steroid injection (TFESI) with contrast and without contrast in treating lumbar radiculopathy. OVERVIEW OF LITERATURE: Epidural injections are one of the most frequently used nonsurgical treatment options for managing lumbar radiculopathy. This study aims to simplify the TFESI technique, which is effective and requires less effort to replicate...
November 10, 2023: Asian Spine Journal
https://read.qxmd.com/read/37941099/changes-in-the-utilization-of-cervicothoracic-injections-between-2010-and-2020
#30
JOURNAL ARTICLE
Philip P Ratnasamy, Oghenewoma P Oghenesume, Gwyneth C Maloy, Jonathan N Grauer
STUDY DESIGN: Descriptive epidemiologic study. OBJECTIVE: To analyze trends and patient characteristics of those undergoing cervicothoracic transforaminal, interlaminar, and facet injections over time. BACKGROUND: Cervicothoracic transforaminal, interlaminar, and facet injections are considered for varied spinal pathologies. Evolving literature, changing physician preferences, insurance reimbursement policies, and patient factors may influence the utilization of such injections over time...
November 3, 2023: Clinical Spine Surgery
https://read.qxmd.com/read/37927613/persistent-radiculopathy-subsequent-to-selective-nerve-root-block
#31
Ryan J McLoughlin, Annabelle Jin, Eric A Canlas, Franklin E Caldera, Yejia Zhang
Transforaminal selective nerve root blocks are commonly performed for low back pain but are not without risk. This case report describes a 55-year-old man who underwent transforaminal selective nerve root block at the left lumbar (L) 4, L5, and sacral (S) 1 levels for radiating low back pain in the setting of moderate narrowing of the left L4-L5 foramen with impingement on the exiting left L4 nerve roots seen on magnetic resonance imaging (MRI). He developed left foot drop immediately after the procedure and presented to the acupuncture clinic two weeks later with persistent pain, left foot drop, and paresthesia of the left lateral shin...
October 2023: Curēus
https://read.qxmd.com/read/37914542/results-from-an-expedited-spinal-nerve-root-block-clinic-at-a-uk-tertiary-neurosurgical-centre
#32
JOURNAL ARTICLE
Iain Feeley, Ahmed Shahin, Aoife Feeley, Martin Wilby, Andreas Goebel, Maneesh Bhojak, Manish Gupta, Sumit Gulati
STUDY DESIGN: Retrospective Observational Study. INTRODUCTION: Lumbar radicular pain has a prevalence of 3-5%. Level 1 evidence has demonstrated equivalence between surgical and injection treatment. We assess the outcomes from a transforaminal epidural steroid injection clinic in a tertiary neuroscience referral centre. METHODS: We performed an analysis of data from consecutive patients entered into a new internal referral database between August 2018 to May 2021...
October 30, 2023: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://read.qxmd.com/read/37886869/the-effect-of-lumbar-multifidus-cross-sectional-areas-on-transforaminal-epidural-steroid-injection-an-observational-clinical-study
#33
JOURNAL ARTICLE
Rekib Saçaklıdır, Efe Soydemir, Savaş Şencan, Osman Hakan Gündüz
OBJECTIVES: Multifidus has an important role in spinal stability, and multifidus degeneration causes long-term disability and low back pain. This study aimed to investigate the effect of multifidus cross-sectional area on transforaminal epidural steroid injections (TFESI). METHODS: Patients with single-level disc herniation were included in the study. Total multifidus cross-sectional area (TM-CSA) and functional cross-sectional area (FM-CSA) were measured from axial T2 MRI of the patients, and FM-CSA/TM-CSA ratio was calculated for determination of muscle degeneration or fat infiltration...
October 2023: Journal of the Turkish Society of Algology
https://read.qxmd.com/read/37876867/the-effectiveness-of-foraminal-root-block-in-relieving-sciatic-pain-due-to-lumbar-disc-herniation
#34
JOURNAL ARTICLE
Ângelo Santana Guerra, Marcello Oliveira Barbosa, Matheus Moreno DE Oliveira, Rosana Queiroz Coccoli, Angelo Augusto Bongiolo Ganeo, Eduardo José Ferreira Sales
OBJECTIVE: To evaluate the clinical profile, pain improvement, and the need for surgical interventions in patients undergoing transforaminal block with the use of corticosteroids and anesthetics. METHODS: This is a prospective, randomized, double-blind study with 45 patients with unilateral radicular pain in their lower limbs and a single-segment lumbar disc herniation diagnosis. In the intervention group, transforaminal blocks with bupivacaine, dexamethasone, and clonidine were applied and in the control group, distilled water and bupivacaine...
2023: Acta Ortopedica Brasileira
https://read.qxmd.com/read/37869446/does-a-positive-response-to-transforaminal-epidural-steroid-injection-identify-patients-who-can-avoid-surgery-for-two-years
#35
JOURNAL ARTICLE
Aki Fujiwara, Keisuke Watanabe, Hideki Shigematsu, Katsuhiro Kimoto, Mitsuru Ida, Yasuhito Tanaka, Masahiko Kawaguchi
BACKGROUND: Transforaminal epidural steroid injection (TFESI) is widely used to manage lumbar radiculopathy. In clinical settings, patients often undergo repeated transforaminal epidural injections with or without steroid administration. OBJECTIVES: To examine whether a positive response to TFESI at the first month, can in clinical settings, identify patients with radiculopathy who can avoid surgery for two years. Study Design/Setting . This prospective observational study was conducted at an academic medical center...
2023: Pain Research & Management
https://read.qxmd.com/read/37847920/effect-of-radiofrequency-on-dorsal-root-ganglion-versus-transforaminal-steroids-injection-on-tumor-necrosis-factor-alpha-level-in-lumbar-radicular-pain
#36
RANDOMIZED CONTROLLED TRIAL
Wael Fathy, Mona Hussein, Rehab Magdy, Hatem Elmoutaz, Heba Abdellatif, Soha M Abd El Salam, Mariana A Mansour, Dina Y Kassim, Mohamed Abdelbadie
BACKGROUND: The mechanism of pain control with pulsed radiofrequency (PRF) is unclear. OBJECTIVES: We aimed to compare the efficacy of combined PRF on dorsal root ganglion (DRG) with transforaminal epidural steroid injection (TFESI) vs TFESI-alone on pain improvement and serum tumor necrosis factor-alpha (TNF-a) level in lumbar disc-related radicular pain. STUDY DESIGN: Prospective, randomized, controlled trial. SETTING: Neurology and Pain Management clinics...
October 2023: Pain Physician
https://read.qxmd.com/read/37840482/predictors-of-successful-treatment-after-transforaminal-epidural-steroid-injections-in-patients-with-lumbar-disc-herniation
#37
JOURNAL ARTICLE
Mustafa Akif Sariyildiz, Ibrahim Batmaz, Salih Hattapoğlu
BACKGROUND: Epidural steroid injections are common procedures used to treat lumbosacral radicular pain due to lumbar disc herniation (LDH). It is crucial for the clinician to anticipate which patients can benefit from interventional treatment options. OBJECTIVE: This study aimed to examine the effect of radiological and clinical parameters on lumbar transforaminal epidural steroid injections (TFESI)/local anesthetic injection outcomes in patients with LDH. METHODS: This study included 286 patients with LDH (146 males and 140 females)...
October 11, 2023: Journal of Back and Musculoskeletal Rehabilitation
https://read.qxmd.com/read/37838225/efficacy-of-epidural-infiltration-in-the-management-of-pain-and-disability-due-to-acute-and-subacute-lumbosacral-radiculopathy
#38
JOURNAL ARTICLE
Jose Manuel Rabanal Llevot, Amaia Muñoz Alonso, Alberto Taborga Echevarría, Jose Angel Martínez Agueros, Sergio Maldonado Vega
BACKGROUND AND OBJECTIVE: Epidural infiltrations are used for treatment of low back pain and sciatica. Linked to lumbar radiculopathy (lumbosacral radicular syndrome). This study evaluates the efficacy of epidural infiltration by different routes to reduce pain intensity, disability and return to work. METHODS: Is a prospective observational study in one hundred consecutive patients sent to pain unit for severe lumbo-sacral radiculopaty. We analyze the efficacy on pain relief (Visual Analogue Scale) and funcional status at two weeks, one month, and three months after epidural injection of local anesthetics and esteroids with differents approachs (interlaminar, caudal and transforaminal)...
October 12, 2023: Neurocirugía (English Edition)
https://read.qxmd.com/read/37790985/fluoroscopy-guided-robotic-system-for-transforaminal-lumbar-epidural-injections
#39
JOURNAL ARTICLE
Cong Gao, Henry Phalen, Adam Margalit, Justin H Ma, Ping-Cheng Ku, Mathias Unberath, Russell H Taylor, Amit Jain, Mehran Armand
We present an autonomous robotic spine needle injection system using fluoroscopic image-based navigation. Our system includes patient-specific planning, intra-operative image-based 2D/3D registration and navigation, and automatic robot-guided needle injection. We performed intensive simulation studies to validate the registration accuracy. We achieved a mean spine vertebrae registration error of 0.8 ± 0.3 mm, 0.9 ± 0.7 degrees, mean injection device registration error of 0.2 ± 0.6 mm, 1.2 ± 1...
November 2022: IEEE transactions on medical robotics and bionics
https://read.qxmd.com/read/37774183/fulminant-cervical-epidural-hematomas-why-do-they-happen-how-can-we-minimize-their-occurrence-and-what-can-we-do-when-they-do-occur-a-perspective
#40
JOURNAL ARTICLE
Standiford Helm, Mahendra R Sanapati, Carl Noe, Gabor Racz
BACKGROUND: Epidural hematomas after appropriately performed cervicothoracic interlaminar epidural injections have been associated with the rapid onset of neurological symptoms and devastating outcomes, despite prompt identification and treatment. Anticoagulation issues were initially felt to be the problem, but the occurrence of fulminant hematomas in patients without coagulation forced a reassessment of the causes and responses to this problem. OBJECTIVES: To evaluate why fulminant epidural hematomas occur after cervicothoracic epidural injections, with a literature review to survey knowledge about them in the surgical literature, and to offer comments as to what the interventional pain physician can do to minimize their occurrence...
September 2023: Pain Physician
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