Risk of Spinal Cord Injury with Interlaminar Cervical Epidural Steroid Injections, Related to the Dorsal Muscular Artery, and Retrograde Flow

2019 ◽  
pp. 193-194
Author(s):  
Marc J. Yland
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Retrograde Flow ◽  
Steroid Injections ◽  
Muscular Artery ◽  
Epidural Steroid Injections ◽  
Cord Injury ◽  
Cervical Epidural Steroid Injections ◽  
Epidural Steroid

Transforaminal Lumbar and Thoracic Interventions and Ischemic Spinal Cord Injury

2016 ◽  
Author(s):  
Scott E. Glaser ◽  
Rinoo Shah
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Infarction ◽  
Supporting Evidence ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Root Cause ◽  
Cord Injury ◽  
Epidural Steroid ◽  
Ischemic Spinal Cord Injury

Transforaminal epidural steroid injections have been shown to be associated with catastrophic neurologic complications secondary to spinal cord infarction. The reflexive, ad hoc response of practitioners to these injuries has been to recommend risk minimization strategies to prevent embolism of the injected particulate steroids and to use nonparticulate steroids. This focus on distal embolism as the sole or primary cause of catastrophic outcomes lacks conclusive supporting evidence and does not suffice to protect the patient from paraplegia as it fails to address the root cause of the complications. A root cause analysis of the procedure provides evidence that the injection technique itself—the “safe triangle”—creates a risk of arterial damage and sequelae leading to ischemia of the spinal cord. The evidence is strong that the only way to mitigate or eliminate the risk of paraplegia is to use a different technique to perform transforaminal injections: the Kambin triangle approach. This change in technique is the only definitive solution that addresses the root cause of these catastrophic sequelae associated with transforaminal epidural steroid injections. Key Words: Artery of Adamkiewicz, ischemic spinal cord injury, Kambin triangle, safe triangle, transforaminal epidural injection

Cervical epidural steroid injections and spinal cord injuries

2016 ◽  
Vol 16 (10) ◽  
pp. 1163-1166 ◽  
Author(s):  
Adam L. Schreiber ◽  
Brian P. McDonald ◽  
Farid Kia ◽  
Guy W. Fried
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Cervical Epidural Steroid Injections ◽  
Epidural Steroid

Cervical Epidural Steroid Injections for Symptomatic Disc Herniations

2006 ◽  
Vol 19 (3) ◽  
pp. 183-186 ◽  
Author(s):  
Eric L. Lin ◽  
Vi Lieu ◽  
Lee Halevi ◽  
Arya Nick Shamie ◽  
Jeffrey C. Wang
Keyword(s):  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Disc Herniations ◽  
Cervical Epidural Steroid Injections ◽  
Epidural Steroid
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