Translaminar Cervical Epidural Steroid As A Treatment Modality In Cervical Radiculopathy In A Tertairy Level Referral Hospital

10.5580/18ef ◽  
2011 ◽  
Vol 8 (2) ◽  
Keyword(s):  
Treatment Modality ◽  
Cervical Radiculopathy ◽  
Referral Hospital ◽  
Epidural Steroid

Cervical Radiculopathy Caused by a Vertebral Artery Loop: Is a Focused Fluoroscopic‐Guided Cervical Epidural Steroid Injection a Possible Treatment Modality?

Pain Practice ◽  
2020 ◽  
Vol 20 (7) ◽  
pp. 787-791
Author(s):  
Davide Marco Croci ◽  
Eva Koetsier ◽  
Paolo Maino ◽  
Michael Reinert ◽  
Thomas Robert ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Treatment Modality ◽  
Steroid Injection ◽  
Cervical Radiculopathy ◽  
Epidural Steroid Injection ◽  
Epidural Steroid

scholarly journals Spinal Cord Infarction after Cervical Transforaminal Epidural Steroid Injection: Case Report and Literature Review

2017 ◽  
Vol 9 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Jangsup Moon ◽  
Hyung-Min Kwon
Keyword(s):  
Spinal Cord ◽  
Steroid Injection ◽  
Cervical Radiculopathy ◽  
Epidural Steroid Injection ◽  
Spinal Cord Infarction ◽  
Catastrophic Event ◽  
History Of ◽  
Transforaminal Epidural Steroid Injection ◽  
Active Rehabilitation ◽  
Epidural Steroid

Introduction: Transforaminal epidural steroid injection (TFESI) is a widely used nonsurgical procedure in the treatment of patients with radiculopathy. It is efficacious in relieving pain, but a number of complications are being reported. Recently, increasing frequency of major complications, such as spinal cord infarction and cerebral infarction, has been reported with the use of a particulate steroid within fluoroscopic-guided procedures. Methods: We report a 49-year-old man with a history of chronic cervical radiculopathy, who experienced a devastating complication after TFESI. Results: After 2 min of regular TFESI, the patient abruptly experienced muscle weakness in both upper extremities and within 5 min the patient became quadriplegic. Despite active rehabilitation, the patient remained bed-ridden 4 years after the catastrophic event. To our knowledge, this is the first reported case of spinal cord infarction that occurred after TFESI in Korea. Conclusion: Considering the risk of dreadful complications, which appear in an unpredictable manner, TFESI with fluoroscopic guidance should be done only with a nonparticulate steroid.

Is Cervical Epidural Steroid Injection Safe and Efficacious for the Treatment of Cervical Radiculopathy?

2019 ◽  
pp. 1
Author(s):  
Henry H. Yu ◽  
Peter Van Steyn ◽  
Nicholas P. Drayer ◽  
Keith L. Jackson ◽  
Daniel G. Kang
Keyword(s):  
Steroid Injection ◽  
Cervical Radiculopathy ◽  
Epidural Steroid Injection ◽  
Epidural Steroid

Directional Preference Following Epidural Steroid Injection in Three Patients with Acute Cervical Radiculopathy

Pain Practice ◽  
2012 ◽  
Vol 13 (7) ◽  
pp. 559-565 ◽  
Author(s):  
Mehul J. Desai ◽  
Girish Padmanabhan ◽  
Ajai Simbasivan ◽  
Gladys G. Kamanga-Sollo ◽  
Ajay Dharmappa
Keyword(s):  
Steroid Injection ◽  
Cervical Radiculopathy ◽  
Epidural Steroid Injection ◽  
Directional Preference ◽  
Epidural Steroid

scholarly journals Improving the Safety of Transforaminal Epidural Steroid Injections in the Treatment of Cervical Radiculopathy

2011 ◽  
Vol 3;14 (3;5) ◽  
pp. 285-293
Author(s):  
Jon E. Block
Keyword(s):  
Cervical Radiculopathy ◽  
The United States ◽  
Injection System ◽  
Study Endpoint ◽  
Primary Study ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Spinal Injection ◽  
Epidural Steroid ◽  
Versus Test

Background: Unplanned vascular trespass occurs in 20% of cervical transforaminal epidural steroid injections (CTFESI) and rarely results in devastating neurologic complications. The Trucath Spinal Injection System is a novel integrated catheter and needle device that is specifically designed to minimize vascular trespass risk. Objective: To compare the vascular trespass incidence with the Trucath Spinal Injection System versus standard spinal needles during CTFESI treatment in patients with cervical radiculopathy. Study Design: Prospective, multicenter, nonrandomized safety trial. Setting: Six tertiary spinal pain management centers in the United States. Methods: We treated 290 patients (411 levels) with recalcitrant cervical radiculopathy using CTFESI; 129 patients (180 levels) were treated with the Trucath Spinal Injection System (Test group) and 161 patients (231 levels) were treated with standard spinal needles (Control group). All injections were administered via a transforaminal approach. Each site attained IRB approval for this study before any research was performed. The primary study endpoint was vascular trespass per treated level. Secondary endpoints included nerve pain or paresthesia, injection accuracy, device performance measures, and procedural adverse events. Results: Vascular trespass occurred more often (odds ratio (OR): 3.1, 95% Confidence Interval (CI): 1.8-5.4, P < 0.001) in Controls (26.8%, 62/231 levels) versus Test patients (10.6%, 19/180 levels). Radicular pain or paresthesia from device positioning was more frequent (OR: 21.1, 95% CI: 6.9-64.5, P < 0.001) in Controls (26.4%, 61/231) versus Test participants (1.7%, 3/179). Inadequate epiradicular flow was observed in 3.0% (7/231) of Controls and 5.6% (10/179) of Test participants (OR: 0.5, 95% CI: 0.2-1.4, P = 0.22). Based on subjective physician judgment (scale: 1-10), there were no differences between the Test and Control groups, respectively, for ease of use (mean 8.9 vs. 9.0), visualization under fluoroscopy (mean 9.2 vs. 9.0), and overall performance (mean 9.0 vs. 8.6). No additional adverse effects were reported in either treatment group in this clinical study. Limitations: The study did not randomly allocate the type of injection procedure to participants and no clinical outcomes beyond the initial treatment were collected. Conclusions: The Trucath Spinal Injection System demonstrated a statistically significant reduction in the rate of intravenous and intra-arterial trespass, procedural pain, and paresthesia, and has similar accuracy and performance versus standard spinal needles for CTFESI treatment of cervical radiculopathy. Key words: cervical, epidural, radiculopathy, steroid, transforaminal, Trucath, vascular trespass

scholarly journals Patient-Reported Outcomes and Satisfaction after Cervical Epidural Steroid Injection for Cervical Radiculopathy

2019 ◽  
Vol 8 ◽  
Author(s):  
Masoud Hashemi ◽  
Payman Dadkhah ◽  
Mehrdad Taheri ◽  
Mahshid Ghasemi ◽  
Ali Hosseinpoor ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Patient Reported Outcomes ◽  
Steroid Injection ◽  
Cervical Radiculopathy ◽  
Epidural Steroid Injection ◽  
Patient Reported ◽  
The Mean ◽  
Epidural Steroid

Background: Cervical radiculopathy caused by disc herniation is a frequent public health issue with economical and socio-professional impacts. The objective of the present study is to evaluate the patient-reported outcomes and satisfaction from cervical epidural steroid injection during a 2-year follow-up. Materials and Methods: Results based on patients’ reports from a previously performed intervention of cervical epidural steroid injection on patients with cervical radiculopathy due to cervical disc herniation are prospectively collected. Outcome measures are Neck Disability Index (NDI), numerical rating scale (NRS) for pain assessment, and 5-scale patient satisfaction questionnaire (PSQ) plus opioid medication for pain relief, additional injections, and progression to surgery. Results: Of total 37 cases, 34 were available for follow-up after 2-year postoperatively. The mean preoperative NDI was 21.17 and improved to 17.38, and the mean NRS was 7.7 and improved to 5.00; both were statistically significant. Mean patient satisfaction after 2 years was 3.17 out of 5. 11 cases needed additional injections, and 4 of patients proceeded to surgery. Conclusion: We showed that transforaminal cervical epidural steroid injection for cervical radiculopathy is an effective non-surgical treatment option, providing significant pain relief and functional improvement during 2-years follow-up along with higher-than-average patient satisfaction in most of our patients. [GMJ.2019;8:e1478]

scholarly journals Hemorrhagic Infarction of Cerebellum and Brainstem Due to Cervical Epidural Steroid Injection – Case Report and Review of the Literature

2018 ◽  
Vol 8 (4) ◽  
pp. 952-956
Author(s):  
Connie Bao ◽  
Shiping Bao
Keyword(s):  
Steroid Injection ◽  
Adverse Event Reporting System ◽  
Cervical Radiculopathy ◽  
Adverse Event Reporting ◽  
Review Literature ◽  
Epidural Steroid Injection ◽  
Serious Adverse Events ◽  
Painful Condition ◽  
Epidural Steroid Injections ◽  
Epidural Steroid

Radiculopathy is a painful condition usually due to a compressed nerve in the spine. It is reported that cervical radiculopathy has an annual incidence of 83.2 cases per 100 000 people. Cervical epidural steroid injection is one of the main treatments, but it can result in serious adverse events, including loss of vision, stroke, paralysis, and death. A 69-year-old female died after receiving the second of three planned C5/C6 epidural steroid injections. The autopsy revealed extensive hemorrhage and necrosis of the entire right side of the cerebellum and nearby brainstem, and extensive petechial hemorrhage of the left side of the cerebellum. This report discusses the importance of a complete autopsy in the case of death due to cervical epidural steroid injection and reporting the case either to peer review literature or to the Food and Drug Administration Adverse Event Reporting System (F AERS) database.

Clinical Outcomes of Cervical Radiculopathy Following Epidural Steroid Injection

Spine ◽  
2012 ◽  
Vol 37 (12) ◽  
pp. 1041-1047 ◽  
Author(s):  
Sang-Hun Lee ◽  
Ki-Tack Kim ◽  
Dong-Hwan Kim ◽  
Bong-Jae Lee ◽  
Eun-Seok Son ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Steroid Injection ◽  
Cervical Radiculopathy ◽  
Epidural Steroid Injection ◽  
Epidural Steroid
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