Document Detail

Complications of interlaminar cervical epidural steroid injections: a review of the literature.
MedLine Citation:
PMID:  17762818     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: A comprehensive literature review. OBJECTIVES: To review and critically evaluate the past literature focusing on incidence and clinical presentation of complications associated with interlaminar cervical epidural steroid injection (ICESI). The overall goal is to guide the direction of future research and improve clinical care by increasing awareness of complications, their presentations, and management. SUMMARY OF BACKGROUND DATA: Although ICESI is considered a relatively safe procedure, a number of minor and major complications have been reported across the literature. Thus far, reports of complications are limited to retrospective studies, case reports, and data extrapolated from lumbar and thoracic procedures. As a result, the past literature has been of limited value with regard to facilitating both clinical care and future research efforts. METHODS: Medical databases were searched for studies of ICESI. The bibliographies of these papers were then searched as well. Papers focusing on cervical techniques that did not involve injection into the epidural space were discarded, as were studies of thoracic and lumbar spine injections. Reports of complications associated with ICESI were further subdivided into major and minor categories. RESULTS: The reported rate of complications associated with ICESI varied between 0 and 16.8%. CONCLUSION: There are significant limitations in the available literature discussing the complications associated with ICESI, but they strongly suggest that ICESI is a relatively safe procedure. Numerous potential adverse reactions have been associated with ICESI, with the vast majority being minor and transient in nature. However, serious complications may also result and may be technique related. Injectionists should be aware of the clinical presentations, rates, potential consequences, and appropriate techniques to avoid these complications. More studies are needed with specific focus on cervical complication rates, standardization of injection techniques, and differentiation between complications and poor efficacy. In addition, the use of a prospective randomized blinded controlled design would be beneficial.
Arjang Abbasi; Gautam Malhotra; Gerard Malanga; Elie P Elovic; Stuart Kahn
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Spine     Volume:  32     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-31     Completed Date:  2007-09-18     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2144-51     Citation Subset:  IM    
Long Island Spine Specialists, Commack, NY 11725, USA.
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MeSH Terms
Analgesia / adverse effects*
Anti-Inflammatory Agents / administration & dosage*
Cervical Vertebrae
Injections, Epidural / adverse effects
Practice Guidelines as Topic
Radiculopathy / drug therapy*
Severity of Illness Index
Spinal Cord Injuries / etiology*
Steroids / administration & dosage*
Treatment Outcome
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Steroids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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