2015
DOI: 10.2217/pmt.15.17
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Key Safety Considerations when Administering Epidural Steroid Injections

Abstract: Neurological and other complications of epidural steroid injections have been widely discussed in recent years. Consequently, the US FDA issued a warning about serious neurological events, some resulting in death, and consequently is requiring label changes. Neurological adverse events numbering 131, including 41 cases of arachnoiditis, have been identified by the FDA, and 700 cases of fungal meningitis following injection of contaminated steroids. A review of the literature reveals an overwhelming proportion … Show more

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Cited by 39 publications
(21 citation statements)
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“…It was tested first in the lumber area then in the thoracic area[345] which has a greater risk than the lumber area. Furthermore, it was tested in the insertion of an epidural catheter in women in labor.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…It was tested first in the lumber area then in the thoracic area[345] which has a greater risk than the lumber area. Furthermore, it was tested in the insertion of an epidural catheter in women in labor.…”
Section: Discussionmentioning
confidence: 99%
“…This setting causes wasting of time, more workforce recruitment, prolonged learning time, and high running cost. [34] Acoustic puncture assist device (APAD) has been tested and used successfully over the past decade. It has shown reliable results to detect epidural space in both lumbar and thoracic area.…”
Section: Introductionmentioning
confidence: 99%
“…Inaccurate needle passage and steroid deposition into the subarachnoid space may lead to serious complications including post-dural puncture headache, arachnoiditis, and spinal cord injury, among others. 3 Accurate preoperative assessment of the distance a needle must travel to reach the epidural space holds the potential for reducing risks, as well as improving outcomes related to procedure time, radiation exposure, and patient comfort.…”
Section: Introductionmentioning
confidence: 99%
“…1, 2, 3 Accurate preoperative assessment of the distance from the skin to the epidural space holds the potential for reducing the risks of adverse effects from ESI. It was hypothesized that the distance from the skin to the epidural space as measured on preoperative magnetic resonance imaging (MRI) would agree with the distance traveled by a Touhy needle to reach the epidural space during midline, interlaminar ESI.…”
mentioning
confidence: 99%
“…Sadly, all modalities of treatments are increasing rapidly with evidence lacking for many of them. There are also numerous considerations, explosive use and safety, including the interventional techniques that are the subject of this book [11,15,16]. While accurate data is available in the United States and other developed countries, in many countries pain may be undertreated and have a higher prevalence than thought; these people may be unable to enjoy the benefits of new advances in interventional pain management.…”
mentioning
confidence: 99%