The Immediate Adverse Events of Lumbar Interventional Pain Procedures in 4,209 Patients: An Observational Clinical Study

Abstract

Objective Lumbar interventional pain procedures (LIPP) are frequently used in low back pain and show an increasing trend in recent years. LIPP are highly effective when performed by properly trained physicians. However, some adverse events are seen during interventional procedures. Our aim in this study is to determine the immediate adverse events rates of LIPP and to inform our colleagues about possible adverse events. Study Design Retrospective, observational study. Setting A university hospital pain management center. Methods After approval of the institutional ethics committee, a retrospectively evaluation of patients, who received fluoroscopy guided LIPP between January 2015 and December 2020, were performed. This observational study was conducted with 4209 patients who underwent LIPP including epidural steroid injections, sacroiliac and facet joint injections, medial branch blocks or RF, dorsal root ganglion pulse RF, epidural catheter or spinal cord stimulator applications. Results No major adverse events were detected during the procedures. Minor adverse events were detected in a 60 patients and adverse events rate was found to be 1.4% (95% confidence interval [CI]: 1.0–1.8%). Minor adverse events rates vary between 0.7–2.3% according to the procedures type. The most common adverse events was determined as vasovagal reactions (26/60). Facial numbness, cramps, and seizures were detected as rare adverse events. Conclusion There were no major adverse events were seen during 4209 patients. The rate of minor adverse events were 1.4% with no sequelae in any of the events. When evidence-based guidelines are followed, interventional pain procedures are performed safely.

Response to the Letter to the Editor: Comparison of efficacy between transforaminal epidural steroid injection technique without contrast versus with contrast in lumbar radiculopathy: a prospective longitudinal cohort study

“…Any adverse events, regardless of severity, were documented. Sencan et al [ 5 ] in 2022 reported that immediate adverse events in lumbar interventional pain procedures were generally low, which aligns with our findings. We believe that our comprehensive approach to patient care contributed to the lower complication rates observed.…”

Convulsive Syncope as a Complication of Outpatient Procedures: A Case Series and Review of the Literature

“…Based on literature review, vasovagal reactions occurred between a range of 0.6% to 2.6% after any type of injection with zero reports of convulsive syncope. Sencan et al 9 noted that 1 patient experienced a seizure, but did not provide additional details to rule out true seizure versus convulsive syncope. Otherwise, none of the reviewed literature encountered or discussed convulsive syncope.…”

Letter to the Editor: Comparison of efficacy between transforaminal epidural steroid injection technique without contrast versus with contrast in lumbar radiculopathy: a prospective longitudinal cohort study

“…Finally, while even minor complication rates are around 2% [ 5 ], you state that you have not seen any complications in your study. Could you consider this as biases?…”