Magnetic resonance imaging of the lumbar spine after epidural and nerve root injection therapy: evaluation of soft tissue changes

Rothenburg, Thomas von; Drescher, Robert; Koester, Odo; Schmid, G.

doi:10.1016/j.clinimag.2006.03.033

Cited by 4 publications

(1 citation statement)

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“…In recent years, Davidson et al [ 9 ] reported air and needle tracks in MR images acquired within 6 h after epidural injection. von Rothenburg et al [ 10 ] reported soft tissue changes after epidural injection. However, these studies only evaluated MR images of a few patients acquired a short period after epidural injection.…”

Section: Introductionmentioning

confidence: 99%

Effect of epidural corticosteroid injection on magnetic resonance imaging findings

et al. 2017

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BackgroundMagnetic resonance imaging (MRI) of the spine is the preferred diagnostic tool for pathologic conditions affecting the spine. However, in patients receiving epidural corticosteroid injection (ESI) for treatment of spinal diseases, there is a possibility of misreading of MR images because of air or fluid in the epidural space after the injection. Therefore, we defined the characteristics of abnormal changes in MRI findings following an ESI in patients with low back pain.MethodsWe reviewed the medical records of 133 patients who underwent MRI of the lumbar spine within 7 days after ESI between 2006 and 2015.All patients were administered an ESI using a 22-gauge Tuohy needle at the lumbar spine through the interlaminar approach. The epidural space was identified by the loss of resistance technique with air.ResultsThe incidences of abnormal changes in MRI findings because of ESI were 54%, 31%, and 25% in patients who underwent MRI at approximately 24 h, and 2 and 3 days after ESI, respectively. Abnormal MRI findings included epidural air or fluid, needle tracks, and soft tissue changes. Epidural air, the most frequent abnormal finding (82%), was observed in 41% of patients who underwent MRI within 3 days after injection. Abnormal findings due to an ESI were not observed in MR images acquired 4 days after ESI or later.ConclusionsPain physicians should consider the possibility of abnormal findings in MR images acquired after epidural injection using the interlaminar approach and the loss of resistance technique with air at the lumbar spine.

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Section: Introductionmentioning

confidence: 99%