Lumbar epidural and foraminal injections: update.

06:00 EDT 4th September 2010 | BioPortfolio

Summary of "Lumbar epidural and foraminal injections: update."

A fluoroscopy-guided lumbar spine injection procedure may be complicated by immediate paralysis. Twelve cases (five recent and seven published) that occurred between 2002 and 2008 were reviewed (history of lumbar surgery, route of injection, image-guidance, injection of contrast, type of steroid, level of paraplegia, MR imaging features). MRI showed cord ischemia from arterial origin. The high number of patients with prior lumbar spine surgery suggests that the presence of scar tissue could increase the risk of paraplegia. A transforaminal approach was used in all patients without history of lumbar surgery while transforaminal, interlaminar and juxta-zygapophyseal approaches were used in patients with prior lumbar surgery. The high number of cases in France could be explained by the exclusive use of prednisolone acetate which has a higher rate of macro-aggregate formation that could lead to embolization in medullary arteries.


Service de Radiologie Ostéo-articulaire, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75010 Paris, France.

Journal Details

This article was published in the following journal.

Name: Journal de radiologie
ISSN: 0221-0363
Pages: 1079-85


DeepDyve research library

PubMed Articles [2138 Associated PubMed Articles listed on BioPortfolio]

The Clinical Efficacy for Two-Level Transforaminal Epidural Steroid Injections.

Epidural steroid injections have been used in combination with other modalities for the treatment of lumbar radicular pain. The literature has shown that one level lumbar fluoroscopically guided trans...

Thermal QST Phenotypes Associated with Response to Lumbar Epidural Steroid Injections: A Pilot Study.

 Response to lumbar epidural steroid injection in lumbar radicular pain varies. The purpose of this study is to characterize the changes in quantitative sensory testing (QST) phenotypes of subjects ...

Anatomical complications of epidural anesthesia: A comprehensive review.

Epidural anesthesia is a versatile technique widely used in treating lumbar spinal pain syndromes. Complications during these procedures can arise either from needle placement or from administration o...

Lumbar Transforaminal Epidural Steroid Injections: Incidental Extraspinal Findings on Planning Imaging.

Planning imaging performed during CT-guided procedures may occasionally contain important incidental findings. The purpose of this study was to identify and characterize by clinical relevance the extr...

161 Patient-Reported Outcomes After Epidural Steroid Injections vs Surgery for Degenerative Lumbar Disease: A Prospective, Matched Cohort Study.

Despite the widespread use of surgery for degenerative lumbar disease (DLD), the comparative effectiveness of surgery vs epidural steroid injections (ESIs) is not well established. A few studies have ...

Clinical Trials [1769 Associated Clinical Trials listed on BioPortfolio]


Study Objective: To compare patient outcomes following treatment with either the MILD procedure or epidural steroid injections (ESIs) in patients with painful lumbar spinal stenosis exhibi...

Epidural Depth: Comparison Between Thoracic and Epidural Space in Young Children Using Magnetic Resonance Imaging.

The purpose of this study is to evaluate the skin to epidural space depth (thoracic and lumbar) and define the ratio between thoracic and lumbar epidural space in children on the basis of ...

Treatment of Chronic Low Back and Lower Extremity Pain

1. To demonstrate clinically significant improvements in patients undergoing lumbar interlaminar epidurals. Improvement will be assessed in relation to the clinical outcome measu...

Low Dose Extended-release Epidural and Lumbar Plexus Block Compared to Lumbar Plexus Block for Total Hip Resurfacing

At Wake Forest University, the investigators have been using Extended Release Epidural Morphine (EREM), since late 2004, as part of multimodal analgesia in patients having gynecologic surg...

The Influence of Needle-insertion Depth on Successful Epidurogram and Clinical Outcome in Caudal Epidural Injections

Caudal epidural injections have been commonly performed in patients with low back pain and radiculopathy. Conventional caudal epidural injections, which the needle is advanced into the sac...

Medical and Biotech [MESH] Definitions

The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.

The injection of autologous blood into the epidural space either as a prophylactic treatment immediately following an epidural puncture or for treatment of headache as a result of an epidural puncture.

The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.

A rare epidural hematoma in the spinal epidural space, usually due to a vascular malformation (CENTRAL NERVOUS SYSTEM VASCULAR MALFORMATIONS) or TRAUMA. Spontaneous spinal epidural hematoma is a neurologic emergency due to a rapidly evolving compressive MYELOPATHY.

Circumscribed collections of suppurative material occurring in the spinal or intracranial EPIDURAL SPACE. The majority of epidural abscesses occur in the spinal canal and are associated with OSTEOMYELITIS of a vertebral body; ANALGESIA, EPIDURAL; and other conditions. Clinical manifestations include local and radicular pain, weakness, sensory loss, URINARY INCONTINENCE, and FECAL INCONTINENCE. Cranial epidural abscesses are usually associated with OSTEOMYELITIS of a cranial bone, SINUSITIS, or OTITIS MEDIA. (From Adams et al., Principles of Neurology, 6th ed, p710 and pp1240-1; J Neurol Neurosurg Psychiatry 1998 Aug;65(2):209-12)

Quick Search
DeepDyve research library

Relevant Topic

Radiology is the branch of medicine that studies imaging of the body; X-ray (basic, angiography, barium swallows), ultrasound, MRI, CT and PET. These imaging techniques can be used to diagnose, but also to treat a range of conditions, by allowing visuali...