Complications of Fluoroscopically Guided Cervical Interlaminar Epidural Steroid Injections
- PDF / 252,274 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 25 Downloads / 197 Views
ANESTHETIC TECHNIQUES IN PAIN MANAGEMENT (D WANG, SECTION EDITOR)
Complications of Fluoroscopically Guided Cervical Interlaminar Epidural Steroid Injections Andrew Chang 1 & Dajie Wang 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Cervical interlaminar epidural steroid injection is a common intervention in the management of cervical radiculitis. Given the large number of injections done annually, it is important to assess the potential complications associated with this procedure. Recent Findings Based on current published studies, the overall complication rate varies. The vast majority are minor complications. However, this review also identified potentially catastrophic complications following cervical interlaminar epidural steroid injections. Summary Based upon our review, cervical epidural steroid injection is considered a safe intervention. Nevertheless, catastrophic complications such as spinal cord injuries from needle placement, infections, and epidural hematoma can occur. It is prudent to take appropriate measures to minimize these complications. Keywords Cervical radiculitis . Cervical interlaminar epidural injection . Cervical epidural steroid injection . Epidural hematoma . Spinal cord injury . Epidural abscess
Introduction Cervical radiculitis is a common cause of axial neck and arm pain. It is characterized by pain radiating in a dermatomal distribution with numbness, weakness, and/or altered reflexes. Pain related to cervical radiculitis has a reported incidence rate of 83 per 100,000 people in the USA [1]. Conservative management of radicular symptoms should be considered first with activity modification, medications (e.g., NSAIDs, neuroleptic agents, and acetaminophen), physical therapy, acupuncture, and wearing cervical orthoses. If there is no improvement with these conservative measures, cervical epidural injections are considered the next step treatment. There are roughly 200,000 CESI injections performed annually [2]. Given the large number of injections done annually, it is important to assess the potential complications associated with This article is part of the Topical Collection on Anesthetic Techniques in Pain Management * Dajie Wang [email protected] 1
Thomas Jefferson University Hospital, Philadelphia, PA, USA
this procedure. The purpose of this study is to review and summarize all the complications associated with CESI.
Methods A literature review was performed to assess adverse events associated with CESI. A PubMed and Google Scholar search with the keywords “fluoroscopic guided cervical interlaminar epidural steroid injections” and “complications of fluoroscopic guided cervical interlaminar epidural injections and cervical epidural steroid injection under fluoroscopic guidance” were performed. Inclusion criteria included any retrospective or prospective studies or case reports prior to September 2019 and studies that were published in English. Exclusion criteria included unclear, thoracic, lumbar caudal and transforam
Data Loading...
