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Transforaminal epidural

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https://www.readbyqxmd.com/read/29138074/outcome-of-transforaminal-epidural-steroid-injection-according-to-the-severity-of-cervical-foraminal-stenosis
#1
Min Son Kim, Dong Gyu Lee, Min Cheol Chang
BACKGROUND CONTEXT: Cervical transforaminal epidural steroid injection (TFESI) is considered one of the most effective treatments for radicular pain induced by cervical foraminal stenosis. PURPOSE: To evaluate the treatment outcome of TFESI according to the severity of cervical foraminal stenosis DESIGN: Retrospective study. PATIENT SAMPLE: Fifty-three patients with cervical radiculopathy due to cervical foraminal stenosis. OUTCOME MEASURES: Pain intensity was evaluated using a numeric rating scale (NRS) at pretreatment, 2 weeks, and 1, 2, and 3 months after TFESI...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29116946/spinal-cord-injury-by-direct-damage-during-ct-guided-c7-transforaminal-epidural-steroid-injection-a-case-report
#2
Min Cheol Chang
Cervical transforaminal epidural steroid injection (TFESI) under the guidance of computed tomography (CT) can offer great anatomical resolution and precise needle placement in the axial plane. However, some complications, including blood pressure surge, allergic reactions, vasovagal syncope, and cerebral infarct, have been reported after CT-guided cervical TFESI. We report the first case of iatrogenic spinal cord injury (SCI) during a CT-guided cervical TFESI. A 67-year-old woman, upon receiving TFESI on Lt...
November 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29099886/risk-of-osteoporotic-fracture-after-steroid-injections-in-patients-with-medicare
#3
Leah Y Carreon, Kevin L Ong, Edmund Lau, Steven M Kurtz, Steven D Glassman
To further evaluate the relationship between steroid injections and osteoporotic fracture risk, we analyzed Medicare administrative claims data on both large-joint steroid injections (LJSIs) into knee and hip and transforaminal steroid injections (TSIs), as well as osteoporotic hip and wrist fractures. Our hypothesis was that a systemic effect of steroid injections would increase fracture risk in all skeletal locations regardless of injection site, whereas a local effect would produce a disproportionate increased risk of spine fracture with spine injection...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29074369/transient-hypokalemic-quadriplegia-following-a-lumbar-transforaminal-epidural-dexamethasone-injection-a-case-report
#4
Maryam Tahmasbi Sohi, William J Sullivan, Dustin J M Anderson
A 30-year-old male with no significant past medical history presented with hypokalemic quadriplegia four hours after he received a lumbar transforaminal epidural steroid injection (TFESI) containing dexamethasone and lidocaine. A comprehensive work up ruled out acquired and hereditary causes of hypokalemic paralysis. Symptoms gradually resolved within hours after potassium restoration with no residual neurologic deficits. Paralysis after TFESI is uncommon, but has been associated with particulate steroids that can coalesce into aggregates and occlude vessels...
October 23, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29051967/clinical-efficacy-of-transforaminal-epidural-injection-for-management-of-zoster-associated-pain-a-retrospective-analysis
#5
Eung Don Kim, Ha Hyeon Bak, Dae Hyun Jo, Hue Jung Park
OBJECTIVES: Transforaminal epidural injection (TFEI) has superior accessibility to the dorsal root ganglion, which is an essential location of pain signaling in herpes zoster. However, the effectiveness of TFEI for herpes zoster patients has not previously been studied. We retrospectively analyzed the efficacy of TFEI for pain control and prevention of PHN in patients with acute and subacute herpes zoster. METHODS: Medical records of 137 patients who underwent TFEI for zoster-associated pain (ZAP) were reviewed...
October 19, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29050895/minimal-invasive-lumbar-spine-revision-surgery-at-distance-from-the-dura-and-postsurgical-scar-tissue-extraforaminal-lumbar-interbody-fusion-elif
#6
Arthur R Kurzbuch, Didier Recoules-Arche
Lumbar spine revision surgery is considered as challenging and related to longer operation time and complications because of the loss of anatomical landmarks and the formation of postoperative epidural fibrosis. Minimal invasive lumbar spinal surgery techniques have been refined over the last 5 years but the reexposure of the dura, the formation of postsurgical scar tissue and related dural tears remain a source of complications. For lumbar spinal revision surgery we advocate the minimal invasive Extraforaminal Lumbar Interbody Fusion (ELIF) technique...
October 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29017311/posterior-epidural-herniation-of-a-lumbar-disk-fragment-at-l2-3-that-mimicked-an-epidural-hematoma
#7
Jin-Sang Kil, Jong-Tae Park
Lumbar disk herniation is common. Because of the posterior longitudinal ligament, migration usually occurs into the ventral epidural space. Rarely, fragments migrate into the dorsal epidural space. A 57-year-old man presented with lower back pain and weakness on right hip flexion and right knee flexion. He had lower back pain 1 day previously and received a transforaminal epidural block at a local hospital. The next day, he reported weakness of the right lower extremity. Lumbar spine magnetic resonance imaging revealed a dorsal epidural lesion with compression of the thecal sac at L2-3...
September 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/29016866/anesthetic-test-dose-and-seizure-risk-with-cervical-transforaminal-epidural-steroid-injection
#8
Fred DeFrancesch, David O'Brien, Clark C Smith
No abstract text is available yet for this article.
July 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28984097/intra-versus-postoperative-initiation-of-pain-control-via-a-thoracic-epidural-catheter-for-lumbar-spinal-fusion-surgery-a-randomised-trial
#9
Manuel Wenk, Ulf Liljenqvist, Thomas Kaulingfrecks, Simone Gurlit, Thomas Ermert, Daniel M Pöpping, Michael Möllmann
BACKGROUND: Thoracic epidural anesthesia (TEC) is one of the pillars of preoperative pain care. Particularly for spine surgery which causes significant postoperative pain TEC seems like an appealing option. However, beneficial effects of a TEC are questionable when the catheter is not used intraoperatively, a decision that is usually based on the surgeon's wish to perform immediate neurological examination postoperatively. METHODS: 40 patients undergoing transforaminal lumbar interbody fusion surgery (TLIF) were randomized in two groups...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28966685/effects-of-different-anesthesia-methods-on-postoperative-transient-neurological-syndrome-in-patients-with-lumbar-disc-herniation
#10
Shunhong Mao, Chunhua Zhu, Yulin Chang
The objective of the present study was to investigate the effects of different anesthesia methods on postoperative transient neurologic syndrome (TNS) in patients with lumbar disc herniation (LDH). Ninety-six patients with LDH were selected from November 2015 to October 2016 in Cangzhou Central hospital. All patients were treated with percutaneous transforaminal endoscopic discectomy. The patients were randomly divided into the control group and observation group, with 48 patients each. Combined spinal-epidural anesthesia was performed for patients in the control group, while epidural anesthesia was applied in the observation group...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28962912/a-minimum-of-5-year-follow-up-after-lumbar-transforaminal-epidural-steroid-injections-in-patients-with-lumbar-radicular-pain-due-to-intervertebral-disc-herniation
#11
David J Kennedy, Patricia Z Zheng, Matthew Smuck, Zachary L McCormick, Lisa Huynh, Byron J Schneider
BACKGROUND CONTEXT: Patients with lumbosacral radiculopathy from an intervertebral disc herniation are frequently treated by transforaminal epidural steroid injections (TFESIs). The long-term outcomes of these patients are poorly described. PURPOSE: We aimed to determine the long-term outcomes for a homogenous group of patients with acute unilateral lumbar radicular pain due to single-level herniated nucleus after lumbar epidural steroid injection at ≥5 years...
September 28, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28943459/descriptive-cadaveric-study-comparing-the-accuracy-of-ultrasound-versus-fluoroscopic-guidance-for-first-sacral-transforaminal-injections
#12
Bradley F Thompson, Matthew J Pingree, Wenchun Qu, Naveen S Murthy, Nirusha Lachman, Mark Friedrich Hurdle
BACKGROUND: Ultrasound is rarely used for guiding lumbosacral epidural steroid injections due to its technical limitations. For example, sonographic imaging lacks the ability to confirm epidural spread and identify vascular uptake. The perceived risk that these limitations pose to human subjects has precluded any large scale clinical trials to date. OBJECTIVE: To compare the accuracy of ultrasound versus fluoroscopic guidance for first sacral transforaminal epidural injections DESIGN: Cadaveric comparative study using dichotomous outcomes...
September 21, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28936912/epidural-hematoma-development-contralateral-to-dura-after-lumbar-transforaminal-epidural-steroid-injection
#13
Semih Gungor, Rohit Aiyer
AIM: To illustrate the anatomical and pathophysiological risks of epidural hematoma formation, other than direct needle trauma, after lumbar transforaminal epidural steroid injection in the setting of severe central canal stenosis. CASE REPORT: This case report presents the development of an epidural hematoma after lumbar transforaminal epidural steroid injection in a patient who has anatomical risk factor of severe lumbar spinal stenosis. The anatomic location of epidural hematoma was at the injected level, but on the contralateral side of the dura at a distance from the needle path...
September 2017: Pain Management
https://www.readbyqxmd.com/read/28934790/factors-associated-with-successful-responses-to-transforaminal-balloon-adhesiolysis-for-chronic-lumbar-foraminal-stenosis-retrospective-study
#14
Doo Hwan Kim, Seong-Sik Cho, Yeon-Jin Moon, Koo Kwon, Kunhee Lee, Jeong-Gil Leem, Jin-Woo Shin, Ji Hyun Park, Seong-Soo Choi
BACKGROUND: Recently, transforaminal balloon adhesiolysis was introduced to manage patients with chronic radicular pain occurring with or without low back pain. However, the factors associated with successful responses to transforaminal balloon adhesiolysis are not known. OBJECTIVE: To evaluate the factors associated with successful responses to transforaminal balloon adhesiolysis for chronic lumbar spinal stenosis. STUDY DESIGN: This is a retrospective observational study...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28928574/impact-of-different-approaches-of-epidural-steroid-injection-on-outcome-of-patients-treated-for-low-backache
#15
Sukhdeep Kaur, Ruchi Gupta, Saru Singh, Raj Kumar, Kulvinder Singh
OBJECTIVES: The objective of this study was to evaluate the clinical efficacy of epidural steroid injections through different approaches using pain relief and improvement in functional capacity as outcome measures. MATERIALS AND METHODS: Sixty patients with low backache and unilateral radiculopathy were randomly assigned to three groups of twenty patients each, for undergoing lumbar epidural steroid injection (LESI) through midline, transforaminal, and paramedian approaches under fluoroscopic guidance...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28914617/distribution-patterns-of-the-vulnerable-vessels-around-cervical-nerve-roots-a-computed-tomography-based-study
#16
Donghwi Park
OBJECTIVE: The aim of the study was to evaluate the prevalence of vulnerable vessels around the target of cervical transforaminal epidural steroid injection at the C3-C7 cervical nerve root levels in a clinical setting. DESIGN: Retrospective, cross-sectional study was conducted. PARTICIPANTS: Patients complaining of neck or arm pain with no previous surgical history and who had undergone both precontrast and contrast-enhanced neck computed tomography were included retrospectively...
September 13, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28881110/endoscopic-spine-surgery
#17
REVIEW
Gun Choi, Chetan S Pophale, Bhupesh Patel, Priyank Uniyal
Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28869902/acute-effects-of-anesthetic-lumbar-spine-injections-on-temporal-spatial-parameters-of-gait-in-individuals-with-chronic-low-back-pain-a-pilot-study
#18
Carl L Herndon, MaryBeth Horodyski, Heather K Vincent
This study examined whether epidural injection-induced anesthesia acutely and positively affected temporal spatial parameters of gait in patients with chronic low back pain (LBP) due to lumbar spinal stenosis. Twenty-five patients (61.7±13.6years) who were obtaining lumbar epidural injections for stenosis-related LBP participated. Oswestry Disability Index (ODI) scores, Medical Outcomes Short Form (SF-36) scores, 11-point Numerical pain rating (NRSpain) scores, and temporal spatial parameters of walking gait were obtained prior to, and 11-point Numerical pain rating (NRSpain) scores, and temporal spatial parameters of walking gait were obtained after the injection...
October 2017: Gait & Posture
https://www.readbyqxmd.com/read/28838872/the-value-of-short-term-pain-relief-in-predicting-the-long-term-outcome-of-lumbar-transforaminal-epidural-steroid-injections
#19
Holger Joswig, Armin Neff, Christina Ruppert, Gerhard Hildebrandt, Martin Nikolaus Stienen
BACKGROUND: A previous report demonstrated predictive power of short-term leg pain relief after lumbar transforaminal epidural steroid injections for 1-month treatment response. The question whether the long-term response could be similarly predicted remained unanswered. METHODS: A prospective cohort of 57 patients who underwent a transforaminal epidural steroid injection for sciatica secondary to a lumbar disc herniation was followed for 24 months. Leg and back pain on the visual analog scale, health-related quality of life using the 12-Item Short Form Survey, and functional outcome using the Oswestry Disability Index were assessed...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28758078/contrast-spread-in-the-superoposterior-approach-of-transforaminal-epidural-steroid-injections-for-lumbosacral-radiculopathy
#20
Young Cheol Jeong, Chung Ho Lee, Seok Kang, Joon Shik Yoon
OBJECTIVE: To observe the contrast spread in superoposterior transforaminal epidural steroid injection (SP TFESI) and investigate the correlation between spread patterns and efficacy. METHODS: Thirty-one patients with lumbosacral radiculopathy underwent single-level TFESI under fluoroscopy. The final needle tip position was targeted toward the SP quadrant of the intervertebral foramen. To observe the spread, 1 mL of contrast material was injected, followed by a steroid injection...
June 2017: Annals of Rehabilitation Medicine
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