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Transforaminal epidural

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https://www.readbyqxmd.com/read/28340495/residents-learning-curve-of-lumbar-transforaminal-epidural-steroid-injections
#1
Holger Joswig, Sarah Roberta Haile, Gerhard Hildebrandt, Martin Nikolaus Stienen
Background and Study Aims There is a paucity of literature on beginners' training and on its connection with patient safety for transforaminal epidural steroid injections (TFESIs). This study retrospectively assessed the learning curves and associated complications of neurosurgery residents never previously exposed to TFESI and compared them with experienced board-certified faculty neurosurgeons (BCFNs). Material and Methods Procedure time in minutes, dose-area product (DAP) in cGy*cm(2), periprocedural observations, and complications in 354 TFESIs for radicular pain secondary to lumbar disk herniation or lumbar spinal stenosis were extracted from operative notes and the electronic infiltration logbook in the per-injection format...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#2
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339445/transforaminal-endoscopic-decompression-for-a-giant-epidural-gas-containing-pseudocyst-a-case-report-and-literature-review
#3
Bin Zhu, Liang Jiang, Xiao Guang Liu
The isolated epidural gas-containing pseudocyst is an uncommon pathogenic factor for severe pain of the lower limb as a result of nerve root compression. After reviewing these rare cases reported in the literature, we found that the name, pathogenesis, and treatment strategy of this pathology remained controversial. The most common treatment is conservative treatment or percutaneous aspiration which might result inpoor pain relief and high recurrence rates. Moreover, the patient who received open surgery had good clinical outcome; however, he or she might experience a significant soft tissue injury...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28298750/comparison-of-fluoroscopic-guided-transforaminal-epidural-injections-of-steroid-and-local-anaesthetic-with-conservative-management-in-patients-with-chronic-lumbar-radiculopathies
#4
Nandita Mehta, Misbah Salaria, A Q Salaria
BACKGROUND: Chronic lumbar radiculopathy is a common medical problem and the treatment modalities used over years have been many ranging from conservative or symptomatic management to open decompression surgery. This study was aimed at to compare two modalities of treatment, i.e., conservative and lumbar transforaminal epidural steroid injections (TFESIs). MATERIALS AND METHODS: A total of 120 patients of American Society of Anesthesiology class - (a healthy patient or a patient with mild systemic disease) were randomized to two groups...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28257294/the-1-year-results-of-lumbar-transforaminal-epidural-steroid-injection-in-patients-with-chronic-unilateral-radicular-pain-the-relation-to-mri-findings-and-clinical-features
#5
Harald Ekedahl, Bo Jönsson, Mårten Annertz, Richard B Frobell
OBJECTIVE: In patients with chronic radicular pain, we aimed to evaluate subgroup differences in 1-yr response to transforaminal epidural steroid injection. DESIGN: In this longitudinal cohort study of 100 subjects, 170 transforaminal epidural steroid injections were performed for 1 yr. The sample was stratified by type of disc herniation (protrusion n = 57, extrusion n = 27), by location of disc herniation (central/subarticular n = 60, foraminal n = 24), by grade of nerve root compression (low-grade compression n = 61, high-grade subarticular nerve compression n = 14, high-grade foraminal nerve compression n = 25), and by positive Slump test (n = 67)...
March 2, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28248888/comparison-between-bipolar-pulsed-radiofrequency-and-monopolar-pulsed-radiofrequency-in-chronic-lumbosacral-radicular-pain-a-randomized-controlled-trial
#6
RANDOMIZED CONTROLLED TRIAL
Min Cheol Chang, Yun Woo Cho, Sang Ho Ahn
BACKGROUND: Chronic lumbosacral radicular pain is a challenging medical problem with respect to therapeutic management. Many patients with lumbosacral radicular pain complain of persistent leg pain after transforaminal epidural steroid injection. Nowadays, pulsed radiofrequency (PRF) stimulation on the dorsal root ganglion (DRG) is widely used for controlling lumbosacral radicular pain. METHODS: We evaluated the effect of bipolar PRF on the DRG for the management of lumbosacral radicular pain...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28209578/intraforaminal-location-of-thoracolumbar-radicular-arteries-providing-an-anterior-radiculomedullary-artery-using-flat-panel-catheter-angiotomography
#7
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/28203184/spinal-cord-infarction-after-cervical-transforaminal-epidural-steroid-injection-case-report-and-literature-review
#8
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
#9
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/28178090/management-of-a-ventral-cerebrospinal-fluid-leak-with-a-lumbar-transforaminal-epidural-blood-patch-in-a-child-with-persistent-postdural-puncture-headache-a-case-report
#10
Genevieve Dʼsouza, F Glen Seidel, Elliot J Krane
OBJECTIVE: Postdural puncture headache (PDPH) is an uncommon sequel of lumbar puncture in children. When conservative treatment with bed rest, hydration, and caffeine are ineffective, epidural blood patches are recommended and are generally effective. The purpose of this report was to highlight that when lumbar epidural blood patches fail to eliminate PDPH, diagnostic evaluation should be performed and alternative treatment sought. CASE REPORT: An unusual case is described of an 11-year-old boy with PDPH, which was successfully managed with a ventral (anterior) epidural blood patch and epidural saline infusion after headache and other symptoms failed to resolve after conservative treatment and conventionally performed blood patches...
March 2017: Regional Anesthesia and Pain Medicine
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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/28028669/transforaminal-migration-of-an-epidural-catheter
#18
Konstantin R F Dirscherl, Sebastian Leschka, Miodrag Filipovic
No abstract text is available yet for this article.
December 27, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28025353/imaging-determinants-of-clinical-effectiveness-of-lumbar-transforaminal-epidural-steroid-injections
#19
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
#20
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
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