Perspective: Risks/adverse events for epidural spinal injections.
Adverse Events
Caudal: Cervical
Cerebrospinal Fluid (CSF) Leaks
Cord Injections
Lumbar
Neurological Deficits
Paralysis
Spinal Epidural Injections: Interlaminar
Transforaminal (TFESI)
Translaminar (ESI)
Vascular Injections
Journal
Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836
Informations de publication
Date de publication:
2024
2024
Historique:
received:
17
08
2024
accepted:
20
08
2024
medline:
7
10
2024
pubmed:
7
10
2024
entrez:
7
10
2024
Statut:
epublish
Résumé
Despite the lack of FDA (Food and Drug Administration) approval, cervical and lumbar epidural spinal injections are frequently performed in the US to address back pain and/or painful radiculopathy. The three major types of injections include; interlaminar/translaminar (ESI), transforaminal (TFESI), or caudal injections. Notably, most studies document little to no clear short-term, and no long-term benefits/efficacy for these injections vs. various placebos. More adverse events (AE) occurred with cervical© rather than lumbar (L) injections, and more severe AE were attributed to C-TFESI vs. CESI injections. Acute post injection AE symptoms were observed immediately or within 72 post-injection hours. These symptoms included; hypotension, acute respiratory distress, chest pain, upper extremity numbness, weakness, paresthesias, paralysis, and fevers. More AE were attributed to cervical C-TFESI vs. cervical CESI. These AE included; intramedullary/cord injections, intravascular injections (i.e. vertebral artery) resulting in brain stem/cerebellar/cord strokes, epidural abscess/infection, confusion, epidural hematomas, intracranial hypotension, and/or 6 Epidural cervical and lumbar ESI or TFESI spinal injections demonstrated minimal to no short-term, and no long-term benefits for the treatment of cervical and/or lumbar pain/radiculopathy vs. placebos. Further, more AE were observed for cervical vs. lumbar epidural injections overall, with more AE usually seen with TFESI vs. ESI procedures.
Sections du résumé
Background
UNASSIGNED
Despite the lack of FDA (Food and Drug Administration) approval, cervical and lumbar epidural spinal injections are frequently performed in the US to address back pain and/or painful radiculopathy. The three major types of injections include; interlaminar/translaminar (ESI), transforaminal (TFESI), or caudal injections. Notably, most studies document little to no clear short-term, and no long-term benefits/efficacy for these injections vs. various placebos.
Methods
UNASSIGNED
More adverse events (AE) occurred with cervical© rather than lumbar (L) injections, and more severe AE were attributed to C-TFESI vs. CESI injections.
Results
UNASSIGNED
Acute post injection AE symptoms were observed immediately or within 72 post-injection hours. These symptoms included; hypotension, acute respiratory distress, chest pain, upper extremity numbness, weakness, paresthesias, paralysis, and fevers. More AE were attributed to cervical C-TFESI vs. cervical CESI. These AE included; intramedullary/cord injections, intravascular injections (i.e. vertebral artery) resulting in brain stem/cerebellar/cord strokes, epidural abscess/infection, confusion, epidural hematomas, intracranial hypotension, and/or 6
Conclusion
UNASSIGNED
Epidural cervical and lumbar ESI or TFESI spinal injections demonstrated minimal to no short-term, and no long-term benefits for the treatment of cervical and/or lumbar pain/radiculopathy vs. placebos. Further, more AE were observed for cervical vs. lumbar epidural injections overall, with more AE usually seen with TFESI vs. ESI procedures.
Identifiants
pubmed: 39372999
doi: 10.25259/SNI_701_2024
pii: 10.25259/SNI_701_2024
pmc: PMC11450889
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
328Informations de copyright
Copyright: © 2024 Surgical Neurology International.
Déclaration de conflit d'intérêts
There are no conflicts of interest.