Techniques in Regional Anesthesia & Pain Management
Volume 13, Issue 4 , Pages 266-271 , October 2009

Epidural steroid injections: An update on mechanisms of injury and safety

References 

  1. Brouwers P, Kottink E, Simon M, et al. A cervical anterior spinal artery syndrome after diagnostic blockade of the right C6 nerve root. Pain. 2001;91:397–399
  2. Rathmell J, Aprill C, Bogduk N. Cervical transforaminal injection of steroids. Anesthesiology. 2004;100:1595–1600
  3. Devor M, Govrin-Lippman R, Raber P. Corticosteroids suppress ectopic neural discharge originating in experimental neuromas. Pain. 1985;22:127–137
  4. Johansson A, Hao J, Sjolund B. Local corticosteroid application blocks transmission in normal nociceptive C-fibres. Acta Anaesthesiol Scand. 1990;34:335–338
  5. Benzon HT. Epidural steroid injections for low back pain and lumbosacral radiculopathy. Pain. 1986;24:277–295
  6. Derby R, Kine G, Saal J, et al. Response to steroid and duration of radicular pain as predictors of surgical outcome. Spine. 1992;17:S176–S178
  7. Houten J, Errico T. Paraplegia after lumbosacral nerve root block: A report of three cases. Spine J. 2002;2:70–75
  8. Huntoon M, Martin D. Paralysis after transforaminal epidural injection and previous spinal surgery. Reg Anesth Pain Med. 2004;29:494–495
  9. Rozin L, Rozin R, Koehler S, et al. Death during transforaminal epidural steroid nerve root block (C7) due to perforation of the left vertebral artery. Am J Forensic Med Pathol. 2003;24:351–355
  10. Baker R, Dreyfuss P, Mercer S, et al. Cervical transforaminal injection of corticosteroids into a radicular artery: A possible mechanism for spinal cord injury. Pain. 2003;103:211–215
  11. Ludwig M. Spinal cord infarction after cervical transforaminal epidural injection: A case report. Arch Phys Med Rehabil. 2003;84:E37
  12. Karasek M, Bogduk N. Temporary neurologic deficit after cervical transforaminal injection of local anesthetic. Pain Med. 2004;5:202–205
  13. Thomas E, Cyteval C, Abiad L, et al. Efficacy of transforaminal versus interspinous corticosteroid injection in discal radiculalgia: A prospective randomized, double-blind study. Clin Rheumatol. 2003;22:299–304
  14. Watts RW, Silagy CA. Meta-analysis and the efficacy of epidural corticosteroids in the treatment of sciatica. Anaesth Intens Care. 1995;223:564–569
  15. Hodges SD, Castelberg RL, Miller T, et al. Cervical epidural steroid injection with intrinsic spinal cord damage: Two case reports. Spine. 1998;23:2137–2142
  16. Nelson D, Landau W. 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
  17. Conners J, Wojack J. Interventional Neuroradiology: Strategies and Practical Techniques. Philadelphia, PA: W. B. Saunders; 1999;
  18. Bagshawe K, Magrath I, Golding P. Intrathecal methotrexate. Lancet. 1969;2:1258
  19. Wybier M. Transforaminal epidural corticosteroid injections and spinal cord infarction. Joint Bone Spine. 2008;75:523–525
  20. Hoeft MA, Rathmell JP, Monsey RD, et al. Cervical transforaminal injection and the radicular artery: Variation in anatomical location within the cervical intervertebral foramina. Reg Anesth Pain Med. 2006;31:270–274
  21. Smuch M, Fuller B, Yoder B, et al. Incidence if simultaneous epidural and vascular injection during lumbosacral transforaminal epidural injections. Spine J. 2007;7:79–82
  22. Huntoon MA. Anatomy of the cervical intervertebral foramina: Vulnerable arteries and ischemic neurologic injuries after transforaminal epidural injections. Pain. 2005;117:104–111
  23. In:  Gilman G,  Goodman L,  Rall T, et al. editor. The Pharmacologic Basis of Therapeutics. New York: Macmillan; 1985;p. 1473–1477
  24. Huntoon MA. Anterior spinal artery syndrome as a complication of transforaminal epidural steroid injections. Semin Pain Med. 2004;2:204–207
  25. Gillilan LA. The arterial blood supply of the human spinal cord. J Comp Neurol. 1958;110:75–103
  26. 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
  27. Donnell C, Cano W, Eramo G. Comparison of of triamconolone to dexamethasone in the treatment of low back and leg pain via lumbar transforaminal epidural steroid injection. Spine J. 2008;8:1S–191S
  28. McMillan MR, Crompton C. Cortical blindness and neurologic injury complicating cervical transforaminal injection for cervical radiculopathy. Anesthesiology. 2003;99:509–511
  29. Pooley RA, McKinney JM, Miller DA. The AAPM/RSNA physics tutorial for residents: Digital fluoroscopy. Radiographics. 2001;21:528–531
  30. Siglar J, Garvan C, McLean J, et al. Digital subtraction: Does it matter? (The rate of intravascular uptake in cervical epidural steroid injections with and without digital subtraction). 2008;Archives of Physical Medicine and Rehabilitation, Academy Annual Assembly Assembly Abstracts, Vol 89, November
  31. Etminan M, Takkouche B, Isoma FC, et al. Risk of ischemic stroke in people with migraine: Systematic review and meta-analysis of observational studies. BMJ. 2005;330:63
  32. Kurunlahti M, Karppinen J, Haapea M, et al. Three year follow-up og lumbar artery occlusion magnetic resonance angiography in patients ith sciatica: Association between occlusion and reported symptoms. Spine. 2004;29:1804–1808

PII: S1084-208X(09)00056-1

doi: 10.1053/j.trap.2009.06.025

Techniques in Regional Anesthesia & Pain Management
Volume 13, Issue 4 , Pages 266-271 , October 2009

Article Tools