Complications of Interlaminar Cervical Epidural Steroid Injections

Abstract

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.

Morphological and radiometrical study of the human intervertebral foramina of the cervical spine

“…The posterior approach to the cervical spine for disc disease and spondylosis remains an important part of the spine surgeon's strategy [9]. However, anatomic studies on cervical foraminotomy are not well established and entail a deep understanding of the surgical anatomy of the intervertebral foramina [1]. Even in the conservative treatment of radiculopathy by traction the thoroughly knowledge of the IVF diameters in different age groups should be taken from the data obtained in this study which can be a useful guide.…”

Cervical epidural steroid injections for symptomatic disc herniations

“…[14][15][16][17][18] Bizim üç olgumuzda da vazovagal reaksiyon gözlenmiş olup hastalara hemen konservatif tedavi uygulanmıştır. Bunun haricinde hastalarımızda başka komplikasyon gelişmemiştir.…”

Cervical Foraminal Versus Interlaminar Epidurals: Risks, Benefits, and Alternatives

“…Consequently, serious complications resulting from cervical interlaminar epidural injections have long been recognized. Published reports document cases of epidural hematoma with various neurologic involvement [59 • , 60, 61], spinal cord injury [62], and death [29]. Closed-claims data demonstrates that a large number of unreported cases also exist [17 •• ].…”

“…Unfortunately, lateral imaging of the lower cervical spine can be obscured by shoulder anatomy, making it difficult to confirm the needle tip position. This has resulted in inadvertent needle advancement and injection into the spinal cord producing a permanent myelopathy [62].…”