Inadvertent Disk Injection during Transforaminal Epidural Steroid Injection: Steps for Prevention and Management
| العنوان: | Inadvertent Disk Injection during Transforaminal Epidural Steroid Injection: Steps for Prevention and Management |
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| المؤلفون: | Sapna R. Kudchadkar, Steven P. Cohen, Sean M. Shockey, Scott R. Griffith, David N. Maine |
| المصدر: | Pain Medicine. 9:688-694 |
| بيانات النشر: | Oxford University Press (OUP), 2008. |
| سنة النشر: | 2008 |
| مصطلحات موضوعية: | Epidural Space, Male, medicine.medical_specialty, Radiography, medicine.medical_treatment, Injections, Epidural, medicine, Humans, Fluoroscopy, Foramen Magnum, Intervertebral Disc, Intervertebral foramen, Aged, Epidural steroid, medicine.diagnostic_test, business.industry, Epidural steroid injection, Disease Management, Magnetic resonance imaging, General Medicine, medicine.disease, Surgery, Analgesia, Epidural, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Anesthesia, Discitis, Steroids, Neurology (clinical), Complication, business, Low Back Pain |
| الوصف: | Objectives. To report two cases of disk injection during transforaminal epidural steroid injection, and to discuss ways to prevent and manage this under-appreciated complication. Design. Case reports and literature reviews. Patients. Two patients with radicular symptoms underwent transforaminal epidural steroid injections under fluoroscopic guidance. The needle in both cases was placed in the center of the intervertebral foramen, about 1 cm above the inferior endplate. Injection of contrast in both cases revealed diskographic spread. Repeat magnetic resonance imaging revealed a large foraminal disk herniation in both patients. Results. A literature search identified three studies whereby the use of a single-needle technique to perform diskography was clearly noted in conjunction with the number of infectious complications. Comparing these data with the incidence of diskitis when a double-needle approach was used found the infectious risk to be considerably higher. There are no data regarding whether imaging studies affect outcomes following epidural steroid injections. Conclusions. These cases and similar complications following transforaminal epidural steroid injections provide anecdotal evidence that recent imaging studies, repeated not only for qualitatively new symptoms but after a sustained quantitative increase in pain, may reduce the complication risk. Data extrapolated from studies on diskitis suggest that administering parenteral, and possibly also intradiskal antibiotics, immediately after inadvertent disk injection is appreciated, may reduce the infectious risk. |
| تدمد: | 1526-4637 1526-2375 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a26e9346472b78b95e17993a8301f06dTest https://doi.org/10.1111/j.1526-4637.2008.00478.xTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....a26e9346472b78b95e17993a8301f06d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15264637 15262375 |
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