Techniques in Regional Anesthesia & Pain Management
Volume 13, Issue 4 , Pages 236-250 , October 2009

Epidural steroid injections: Complications and management

References 

  1. Botwin KP, Gruber RD, Bouchlas CG, et al. Complications of fluoroscopically-guided transforaminal lumbar epidural injections. Arch Phys Med Rehabil. 2000;81:1045–1050
  2. Derby R, Lee SH, Kim BJ, et al. Complications following cervical epidural steroid injections by expert interventionalists in 2003. Pain Physician. 2004;7:445–449
  3. Johnson BA, Schellhas KP, Pollei SR. Epidurography and therapeutic epidural injections: Technical considerations and experience with 5334 cases. AJNR Am J Neuroradiol. 1999;20:697–705
  4. Fitzgibbon DR, Posner KL, Domino KB, et al. Chronic pain management: American Society of Anesthesiologists Closed Claims Project. Anesthesiology. 2004;100:98–105
  5. Ramos GS, Gomes EC. Neuropathic pain after epidural needle trauma. Rev Bras Anestesiol. 2008;58:380–386
  6. Neal JM. Anatomy and pathophysiology of spinal cord injuries associated with regional anesthesia and pain medicine. Reg Anesth Pain Med. 2008;33:423–434
  7. Neal JM, Bernards CM, Hadzic A, et al. ASRA practice advisory on neurologic complications in regional anesthesia and pain medicine. Reg Anesth Pain Med. 2008;33:404–415
  8. Tsui BC, Armstrong K. Can direct spinal cord injury occur without paresthesia? (A report of delayed spinal cord injury after epidural placement in an awake patient). Anesth Analg. 2005;101:1212–1214
  9. Tripathi M, Nath SS, Gupta RK. Paraplegia after intracord injection during attempted epidural steroid injection in an awake-patient. Anesth Analg. 2005;101:1209–1211
  10. Bernards CM, Hadzic A, Suresh S, et al. Regional anesthesia in anesthetized or heavily sedated patients. Reg Anesth Pain Med. 2008;33:449–460
  11. Botwin KP, Castellanos R, Rao S, et al. Complications of fluoroscopically guided interlaminar cervical epidural injections. Arch Phys Med Rehab. 2003;84:627–633
  12. Houten JK, Errico TJ. Paraplegia after lumbosacral nerve root block: Report of three cases. Spine J. 2002;2:70–75
  13. Huntoon MA, Martin DP. Paralysis after transforaminal epidural injection and previous spinal surgery. Reg Anesth Pain Med. 2004;29:494–495
  14. Glaser SE, Falco F. Paraplegia following a thoracolumbar transforaminal epidural steroid injection. Pain Physician. 2005;8:309–314
  15. Huston CW. Cervical epidural steroid injections in the management of cervical radiculitis: Interlaminar versus transforaminal (A review). Curr Rev Musculoskelet Med. 2009;2:30–42
  16. Hogan QH. Epidural anatomy examined by cryomicrotome section. Reg Anesth. 1996;21:395–406
  17. Tiso RL, Cutler T, Catania JA, et al. Adverse central nervous system sequelae after selective transforaminal block: The role of corticosteroids. Spine J. 2004;4:468–474
  18. Young W. Transient blindness after lumbar epidural steroid injection: A case report and literature review. Spine. 2002;27:E476–E477
  19. Abbasi A, Malhotra G, Malanga G, et al. Complications of interlaminar cervical epidural steroid injections: A review of the literature. Spine. 2007;32:2144–2151
  20. Trentman TL, Rosenfeld DM, Seamans DP, et al. Vasovagal reactions and other complications of cervical vs. lumbar translaminar epidural steroid injections. Pain Practice. 2008;9:59–64
  21. Cicala RS, Westbrook L, Angel JJ. Side effects and complications of cervical epidural steroid injections. J Pain Symptom Manage. 1989;4:64–66
  22. Botwin KP, Gruber RD, Bouchlas CG, et al. Complications of fluoroscopically-guided caudal epidural injections. Am J Phys Med Rehabil. 2001;80:416–424
  23. Benyamin RM, Vallejo R, Kramer J, et al. Corticosteroid induced psychosis in the pain management setting. Pain Physician. 2008;11:917–920
  24. Dilke TF, Burry HC, Grahame R. Extradural corticosteroid injection in management of lumbar nerve root compression. Br Med J. 1973;2:635–637
  25. Gilman G, Goodman L, Rall T, et al. In: The Pharmacologic Basis of Therapeutics. New York, NY: Macmillan; 1985;p. 1473–1477
  26. Scanlon GC, Moeller-Bertram T, Romanowsky SM, et al. Cervical transforaminal epidural steroid injections: More dangerous than we think?. Spine. 2007;32:1249–1256
  27. Wybier M. Transforaminal epidural corticosteroid injections and spinal cord infarction: Editorial. Joint Bone Spine. 2008;75:523–525
  28. Pizzimenti JJ, Daniel KP. Central serous chorioretinopathy after epidural steroid injection. Pharmacotherapy. 2005;25:1141–1146
  29. Roy-Camille R, Mazel C, Husson JL, et al. Symptomatic spinal epidural lipomatosis induced by a long-term steroid treatment (Review of the literature and report of two additional cases). Spine. 1991;16:1365–1371
  30. Sandberg DI, Lavyne MH. Symptomatic spinal epidural lipomatosis after local epidural corticosteroid injections: Case report. Neurosurgery. 1999;45:162–165
  31. Gottlieb NL, Riskin WG. Complications of local corticosteroid injections. J Am Med Assoc. 1980;243:1547–1548
  32. Spaccarelli K. Lumbar and caudal epidural corticosteroid injections. Mayo Clin Proc. 1996;71:169–178
  33. Younes M, Neffati F, Touzi M, et al. Systemic effects of epidural and intra-articular glucocorticoid injections in diabetic and non-diabetic patients. Joint Bone Spine. 2007;74:472–476
  34. Goebert HW, Jallo SJ, Gardner WJ, et al. Painful radiculopathy treated with epidural injections of procaine and hydrocortisone acetate: Results in 113 patients. Anesth Analg. 1961;40:130–134
  35. Maillefert JF, Aho S, Huguenin MC, et al. Systemic effect of epidural injections with dexamethasone. Rev Rhum. 1995;62:453–456
  36. Craig DB, Habib GG. Flaccid paraparesis following obstetrical epidural anesthesia (Possible role of benzyl alcohol). Anesth Analg. 1977;56:219–222
  37. Tuel SM, Meythaler JM, Cross LL. Cushing's syndrome from methylprednisolone. Pain. 1990;40:81–84
  38. Abram SE, O'Connor TC. Complications associated with epidural steroid injections. Reg Anesth. 1996;21:149–162
  39. Knight CL, Burnell JC. Systemic side-effects of extradural steroids. Anaesthesia. 1980;35:593–594
  40. Stambough JL, Booth RE, Rothman RH. Transient hypercorticism after epidural steroid injection. J Bone Joint Surg. 1984;66A:1115–1116
  41. Boonen S, Van Diestel G, Westhovens R, et al. Steroid myopathy induced by epidural triamcinolone injection. Br J Rheumatol. 1995;34:385–386
  42. Morris JT, Konkol KA, Longfield RN. Chemical meningitis following epidural steroid injection. Infect Med. 1994;11:439–440
  43. Nelson DA, Landau WM. Intraspinal steroids: History, efficacy, accidentality, and controversy with review of United States Food and Drug Administration reports. J Neurol Neurosurg Psychiatry. 2001;70:433–443
  44. Nelson D. Complications from intrathecal steroid therapy in patients with multiple sclerosis. Acta Neurol Scand. 1973;49:176–188
  45. Bernat JL, Sadowsky CH, Vincent FM, et al. Sclerosing spinal pachymeningitis (A complication of intrathecal administration of Depo-Medrol for multiple sclerosis). J Neurol Neurosurg Psychiatry. 1976;39:1124–1128
  46. Carta F, Canu C, Datti R, et al. Calcification and ossification of the spinal arachnoid after intrathecal administration of Depo-Medrol. Zentralbl Neurochir. 1987;48:256–261
  47. Mount H. In:  Morley TP editors. Current Controversies in Neurology. Philadelphia, PA: W. B. Saunders; 1976;p. 67–72
  48. Tsui BC, Malherbe S, Koller J, et al. Reversal of an unintentional spinal anesthetic by cerebrospinal lavage. Anesth Analg. 2004;98:434–436
  49. Bilir A, Gulec S. Cauda equina syndrome after epidural steroid injection: A case report. J Manipulat Physiol Ther. 2006;29:492–494
  50. Kubina P, Gupta A, Oscarsson A, et al. Two cases of cauda equina syndrome following spinal-epidural anesthesia. Reg Anesth Pain Med. 1997;22:447–450
  51. Souadjian JV, Cain JC. Intractable hiccup (Etiologic factors in 220 cases). Postgrad Med. 1968;43:72–77
  52. Slipman CW, Shin CH, Patel RK, et al. Persistent hiccup associated with thoracic epidural injection. Am J Med Rehabil. 2001;80:618–621
  53. McAllister RK, McDavid AJ, Meyer TA, et al. Recurrent persistent hiccups after epidural steroid injection and analgesia with bupivacaine. Anesth Analg. 2005;100:1834–1836
  54. Diagnostic Products Monograph for Isovue 1984: Data on File. Princeton, NJ: Squibb, Institute for Medical Research, E R Squibb & Sons; 1984;
  55. Astra Pharmaceuticals. Package Insert: Xylocaine. Westborough, MA: Astra Pharmaceuticals; 1997;
  56. Yamaguchi K, Kozuka T, Takashima T, et al. Adverse reactions to ionic and non-ionic cContrast media: A report from the Japanese Committee on the Safety of Contrast Media. Radiology. 1990;175:621–628[Comments in: Radiology 175:616-618, 1990; 178:787-790, 1991]
  57. Drayer BP. A double-blind clinical trial of iopamidol versus metrizamide for lumbosacral myelography. J Neurosurg. 1983;32:320–321
  58. Goodman BS, Bayazitoglu M, Mallempati S, et al. Dural puncture and subdural injection: A complication of lumbar transforaminal epidural injections. Pain Physician. 2007;10:697–705
  59. Ito R. The treatment of low back pain and sciatica with epidural corticosteroids injection and its pathophysiological basis. J Jpn Orthop Assoc. 1971;45:769–777
  60. Botwin KP, Rao BM. Adverse effects of fluoroscopically guided interlaminar thoracic epidural steroid injections. Am J Phys Med Rehabil. 2006;85:14–23
  61. Beliveau P. A comparison between epidural anesthesia with and without corticosteroids in the treatment of sciatica (Rheum). Phys Med. 1971;11:40–43
  62. Abram SE, Cherwenka RW. Transient headache immediately following epidural steroid injection. Anesthesiology. 1979;50:461–462
  63. Katz JA, Lukin R, Bridenbaugh PO, et al. Subdural intracranial air: And unusual cause of headache after epidural steroid injection. Anesthesiology. 1991;74:615–618
  64. Scott D. Identification of the epidural space: Loss of resistance to air or saline?. Reg Anesth. 1997;22:1–2
  65. Hawley JS, Ney JP, Swanberg MM. Subarachnoid pneumocephalus from epidural steroid injection. Headache. 2005;45:247–248
  66. Simopoulos T, Peeters-Asdourian C. Pneumocephalus after cervical epidural steroid injection. Anesth Analg. 2001;92:1576–1577
  67. Lehmann LJ, Pallares VS. Subdural injection of a local anesthetic with steroids: Complication of epidural anesthesia. South Med J. 1995;88:467–469
  68. Finn KP, Case JL. Disk entry: A complication of transforaminal epidural injection—A case report. Arch Phys Med Rehabil. 2005;86:1489–1491
  69. Lee J-H. Spinal cord injury produced by direct damage during cervical transforaminal epidural injection. Reg Anesth Pain Med. 2008;33:377–379
  70. Ho KY, Manghnani P. Acute monoplegia after lysis of epidural adhesions: A case report. Pain Practice. 2008;8:404–407
  71. Field J, Rathmell JP, Stephenson JH, et al. Neuropathic pain following cervical epidural steroid injection. Anesthesiology. 2000;93:885–888
  72. Hlavin ML, Kaminski HJ, Ross JS, et al. Spinal epidural abscess: A ten-year perspective. Neurosurgery. 1990;27:177–184
  73. Reihsaus E, Waldbaur H, Seeling W. Spinal epidural abscess: A meta-analysis of 915 patients. Neurosurg Rev. 2000;23:175–204
  74. Kolmos H. Spinal epidural abscess in patients on maintenance haemodialysis (a presentation of two cases). Int Urol Nephrol. 1979;11:249–253
  75. Hefter H, Piontek M, Aulich A. Bacterial meningitis and dorsal spinal epidural abscess caused by Crohn's disease. Neurology. 1991;41:606–608
  76. Dei-Anang K, Hase U, Schurmann K. Epidural spinal abscesses. Neurosurg Rev. 1990;13:285–288
  77. Williams JW, Powell T. Epidural abscess of the cervical spine: Case report and literature review. Br J Radiol. 1990;63:576–578
  78. Van Winter JT, Nielsen SN, Ogburn PL. Epidural abscess associated with intravenous drug abuse in a pregnant patient. Mayo Clin Proc. 1991;66:1036–1039
  79. Brown SM, Stimmel B, Taub RN, et al. E. Immunologic dysfunction in heroin addicts. Arch Intern Med. 1974;134:1001–1006
  80. Broner FA, Garland DE, Zigler JE. Spinal infections in the immunocompromised host. Orthop Clin North Am. 1996;27:37–46
  81. Del Curling O, Gower DJ, McWhorter JM. Changing concepts in spinal epidural abscess: A report of 29 cases. Neurosurgery. 1990;27:185–192
  82. Harding SA, Collis RE, Morgan BM. Meningitis after combined spinal-extradural anaesthesia in obstetrics. Br J Anaesth. 1994;73:545–547
  83. De Leon Cassasola OA, Myers DP, Rempel J, et al. A prospective analysis of epidural migration in 1598 surgical cancer patients. Anesthesiology. 1991;75:A730
  84. Kaufman DM, Kaplan JG, Litman N. Infectious agents in spinal epidural abscesses. Neurology. 1980;30:844–850
  85. Khanna RK, Malik GM, Rock JP, et al. Spinal epidural abscess: Evaluation of factors influencing outcome. Neurosurgery. 1996;39:958–964
  86. Khwaja MS, Dossetor JF, Lawrie JH. Extradural guinea-worm abscess (Report of two cases). J Neurosurg. 1975;43:627–630
  87. Sapunar J, Gambini L. Vertebral hydatidosis with extra- and intra-rachidian hydatid ossifluent pseudoabscess. Bol Chil Parasitol. 1993;48:18–25
  88. El Andaloussi M, Yousri B, Aboumaarouf M. Vertebral hydatidosis: Three case reports. Rev Chir Orthop Reparatrice Appar Mot. 2001;87:392–396
  89. Saigal G, Donovan Post MJ, Kozic D. Thoracic intradural Aspergillus abscess formation following epidural steroid injection. AJNR J Neuroradiol. 2004;25:642–644
  90. Baker AR, Raffin TA, van Houten FX. Spinal epidural abscess. N Engl J Med. 1975;293:463–468
  91. Waldman SD. Complications of cervical epidural nerve blocks with steroids: A prospective study of 790 consecutive blocks. Reg Anesth. 1989;14:149–151
  92. Kaufman DM, Kaplan JG, Litman N. Infectious agents in spinal epidural abscesses. Neurology. 1980;30:844–850
  93. Huang RC, Shapiro GS, Lim M, et al. Cervical epidural abscess after epidural steroid injection. Spine. 2004;29:E7–E9
  94. Hooten WM, Kinney MO, Huntoon MA. Epidural abscess and meningitis after epidural corticosteroid injection. Mayo Clin Proc. 2004;79:682–686
  95. Chan ST, Leung S. Spinal epidural abscess following steroid injection for sciatica (Case report). Spine. 1989;14:106–108
  96. Duc C, Grange L, Gaudin P, et al. Extensive primary epidural abscess (Report of a case). Joint Bone Spine. 2002;69:312–315
  97. Makiuchi T, Kondo T, Yamakawa K. Stellate ganglion blocks as the suspected route of infection in a case of cervical epidural abscess. No Shinkei Geka. 1993;21:805–808
  98. Hooten WM, Mizerak A, Carns PE, et al. Discitis after lumbar epidural corticosteroid injection: A case report and analysis of the case report literature. Pain Med. 2006;7:46–51
  99. Simopoulos TT, Kraemer JJ, Glazer P, et al. Vertebral osteomyelitis: A potentially catastrophic outcome after lumbar epidural steroid injection. Pain Physician. 2008;11:693–697
  100. Bibbo C, Patel DV, Gehrmann RM, et al. Chlorhexidine provides superior skin decontamination in foot and ankle surgery: A prospective randomized study. Clin Orthop Relat Res. 2005;438:204–208
  101. O'Grady NP, Alexander M, Dellinger EP, et al. Guidelines for the prevention of intravascular catheter related infections. MMWR Recomm Rep. 2002;51:1–29
  102. Cooper AB, Sharpe MD. Bacterial meningitis and cauda equina syndrome after epidural steroid injections. Can J Anaesth. 1996;43:471–474
  103. Sabel M, Felsberg J, Neuen-Jacob E, et al. Enlargement of a chronic aseptic lumbar epidural abscess by intraspinal injections—A rare cause of progressive paraparesis. Zentralbl Neurochir. 2000;61:111–114
  104. McGahan JP, Dublin AB. Evaluation of spinal infections by plain radiographs, computed tomography, intrathecal metrizamide, and CT-guided biopsy. Diagn Imaging Clin Med. 1985;54:11–20
  105. Teman AJ. Spinal epidural abscess (Early detection with gadolinium magnetic resonance imaging). Arch Neurol. 1992;49:743–746
  106. Leys D, Lesoin F, Viaud C, et al. Decreased morbidity from acute bacterial spinal epidural abscesses using computed tomography and nonsurgical treatment in selected patients. Ann Neurol. 1985;17:350–355
  107. Shealy CN. Dangers of spinal injections without proper diagnosis. J Am Med Assoc. 1996;197:1104–1106
  108. Sapico FL. Microbiology and antimicrobial therapy of spinal infections. Orthop Clin North Am. 1996;27:9–13
  109. Esposito DP, Gulick TA, Sullivan HG, et al. Acute anterior spinal epidural abscess. South Med J. 1984;77:1171–1172
  110. Bluman EM, Palumbo MA, Lucas PR. Spinal epidural abscess in adults. J Am Acad Orthop Surg. 2004;12:155–163
  111. Tabo E, Ohkuma Y, Kimura S, et al. Successful percutaneous drainage of epidural abscess with epidural needle and catheter. Anesthesiology. 1994;80:1393–1395
  112. Jackson R. Case of spinal apoplexy. Lancet. 1869;2:538–539
  113. Groen RJ. The spontaneous spinal epidural hematoma (A study of the etiology). Neurol Sci. 1990;98:121–138
  114. Bruyn GW, Bosma NJ. Spinal extradural hæmatoma. In:  Vinken PJ,  Bruyn GW editor. Handbook of Clinical Neurology. Amsterdam: North-Holland; 1976;261-230
  115. Miyagi Y, Miyazono M, Kamikaseda K. Spinal epidural vascular malformation presenting in association with a spontaneously resolved acute epidural hematoma (Case report). J Neurosurg. 1998;88:909-901
  116. Schmidt A, Nolte H. Subdural and epidural haematomas following spinal, epidural, or caudal anaesthesia (German). Anaesthetist. 1992;41:276–284
  117. Harris DJ, Fornasier VL, Livingston KE. Hemangiopericytoma of the spinal canal (Report of three cases). J Neurosurg. 1978;49:914–920
  118. Groen RJ, Ponssen H. The spontaneous spinal epidural hematoma (A study of the etiology). J Neurol Sci. 1990;98:121–138
  119. Ofluoğlu E, Ozdemir A, Toplamaoğlu H, et al. Spontaneous cervical epidural hematoma causing Brown-Sequard syndrome. Turk Neurosurg. 2009;19:99–102
  120. Shin YI, Yang CY, Joo MC, et al. Spontaneous epidural hematoma recurred three times. NeuroRehabilitation. 2007;22:147–150
  121. Bewermeyer H, Schumacher A, Neveling M, et al. Hemorrhagic neurologic complications during therapy with anticoagulants and fibrinolytic agents (German). Dtsch Med Wochenschr. 1984;109:165–169
  122. Vandermeulen EP, Van Aken H, Vermylen J. Anticoagulants and spinal-epidural anesthesia. Anesth Analg. 1994;79:1165–1177
  123. Zeidan A, Chaaban M, Farhat O, et al. Cerebral rebleeding by spinal anesthesia in a patient with undiagnosed chronic subdural hematoma. Anesthesiology. 2006;104:613–614
  124. Ozdemir O, Calisaneller T, Yildirim E, et al. Acute intracranial subdural hematoma after epidural steroid injection: A case report. J Manipulative Physiol Ther. 2007;30:536–538
  125. Vaughan DJ, Stirrup CA, Robinson PN. Cranial subdural haematoma associated with dural puncture in labour. Br J Anaesth. 2000;84:518–520
  126. Reitman CA, Watters W. Subdural hematoma after cervical epidural steroid injection. Spine. 2002;27:E174–E176
  127. Morisaki H, Doi J, Ochiai R, et al. Epidural hematoma after epidural anesthesia in a patient with hepatic cirrhosis. Anesth Analg. 1995;80:1033–1035
  128. Wulf H. Epidural anaesthesia and spinal haematoma. Can J Anaesth. 1996;42:1260–1273
  129. Horlocker TT, Wedel DJ. Anticoagulation and neuraxial block: Historical perspective, anesthetic implications, and risk management. Reg Anesth Pain Med. 1998;23:129–134
  130. Yoo HS, Park SW, Han JH, et al. Paraplegia caused by an epidural hematoma in a patient with unrecognized chronic idiopathic thrombocytopenic purpura following an epidural steroid injection. Spine. 2009;34:E376–E379
  131. Williams KN, Jackowski A, Evans PJ. Epidural haematoma requiring surgical decompression following repeated cervical epidural steroid injections for chronic pain. Pain. 1990;42:197–199
  132. Martindale. The Extra Pharmacopea. In:  Reynolds JEL editors. London: Pharmaceutical Press; 1989;p. 872
  133. Domenicucci M, Ramieri A, Passacantilli E, et al. Spinal arachnoiditis ossificans: Report of three cases. Acta Neurochir (Wein). 2005;147:741–750
  134. Masdeu JC, Breuer AC, Schoene WC. Spinal subarachnoid hematomas: Clue to a source of bleeding in traumatic lumbar puncture. Neurology. 1979;29:872–876
  135. Lee SJ, Lin YY, Hsu CW, et al. Intraventricular hematoma, subarachnoid hematoma and spinal epidural hematoma caused by lumbar puncture: An unusual complication. Am J Med Sci. 2009;337:143–145
  136. Karppinen J, Malmivaara A, Kurunlahti M, et al. Periradicular infiltration for sciatica: A randomized controlled trial. Spine. 2001;26:1059–1067
  137. Armon C, Argoff CE, Samuels J, et al. Assessment: Use of epidural steroid injections to treat radicular lumbosacral pain: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2007;68:723–729
  138. Furman MB, Giovanniello MT, O'Brien EM. Incidence of intravascular penetration in transforaminal cervical epidural steroid injections. Spine. 2003;28:21–25
  139. Brouwers PJ, Kottnik EJ, Simon MA, et al. A cervical anterior spinal artery syndrome after diagnosis blockade of the right C6 nerve root. Pain. 2001;91:397–399
  140. Beckman WA, Mendez RJ, Paine GF, et al. Cerebellar herniation after cervical transforaminal epidural injection. Reg Anesth Pain Med. 2006;31:282–285
  141. Muro KM, O'Shaughnessy B, Ganju A. Infarction of the cervical spinal cord following multilevel transforaminal epidural steroid injection: Case report and review of the literature. J Spinal Cord Med. 2007;30:385–388
  142. Suresh S, Berman J, Connell DA. Cerebellar and brainstem infarction as a complication of CY-guided transforaminal cervical nerve root block. Skeletal Radiol. 2007;36:449–452
  143. Smuck M, Fuller BJ, Yoder B, et al. Incidence of simultaneous epidural and vascular injection during lumbosacral transforaminal epidural injections. Spine J. 2007;7:79–82
  144. Smuck M, Fuller BJ, Chiodo A, et al. Accuracy of intermittent fluoroscopy to detect intravascular injection during transforaminal epidural injections. Spine. 2008;33:E205–E210
  145. In:  Bonica JJ editors. The Management of Pain. (ed 2). Philadelphia, PA: Lea & Febiger; 1990;vol 2
  146. Kaplan MS, Cooke J, Collins JG. Intravascular uptake during fluoroscopically guided cervical interlaminar steroid injection at C6-7: A case report. Arch Phys Med Rehabil. 2008;89:553–558
  147. Renfrew DL, Moore TE, Kathol MH, et al. Correct placement of epidural steroid injections: Fluoroscopic guidance and contrast administration. AJNR Am J Neuroradiol. 1991;12:1003–1007
  148. Triantafyllou S. Personal communication. 1999;
  149. Cheshire WP, Santos CC, Massey CW, et al. Spinal cord infarction: Etiology and outcome. Neurology. 1996;47:321–330
  150. Bagshawe KD, Magrath IT, Golding PR. Intrathecal methotrexate. Lancet. 1969;2:1258
  151. Ludwig MA, Burns SP. Spinal cord infarction following cervical transforaminal epidural injection. Spine. 2005;30:E266–E268
  152. Dreyfus P, Baker R, Bogduk N. Comparative effectiveness of cervical transforaminal injections with particulate and nonparticulate corticosteroid preparations for cervical radicular pain. Pain Med. 2006;7:237–242

PII: S1084-208X(09)00039-1

doi: 10.1053/j.trap.2009.06.011

Techniques in Regional Anesthesia & Pain Management
Volume 13, Issue 4 , Pages 236-250 , October 2009

Article Tools