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Complications of fluoroscopically guided transforaminal lumbar epidural injections

Authors
Journal
Archives of Physical Medicine and Rehabilitation
0003-9993
Publisher
Elsevier
Publication Date
Volume
81
Issue
8
Identifiers
DOI: 10.1053/apmr.2000.7166
Keywords
  • Injections
  • Epidural
  • Radiculopathy
  • Spinal Stenosis
  • Herniated Nucleus Pulposus
  • Selective Nerve Root Block
  • Rehabilitation
Disciplines
  • Design
  • Medicine

Abstract

Abstract Botwin KP, Gruber RD, Bouchlas CG, Torres-Ramos FM, Freeman TL, Slaten WK. Complications of fluoroscopically guided transforaminal lumbar epidural injections. Arch Phys Med Rehabil 2000;81:1045-50. Objectives: To assess the incidence of complications of fluoroscopically guided lumbar transforaminal epidural injections. Design: A retrospective cohort design study. Patients presenting with radiculopathy, caused by either lumbar spinal stenosis or herniated nucleus pulposus confirmed by magnetic resonance imaging or computed tomography scanning, received transforaminal epidural steroid injections as part of a conservative care treatment plan. Setting: A multidisciplinary spine care center. Intervention: All injections were performed consecutively over a 4-month period by five physiatrists. An independent observer reviewed medical charts, which included a 24-hour postprocedure telephone call by an ambulatory surgery center nurse who had asked a standardized questionnaire about complications following the injections. Physician follow-up office notes 1 to 3 weeks after the injection, along with epiduragrams, were also reviewed. Results: Two hundred seven patients who received 322 injections were reviewed. Complications per injection seen included 10 transient nonpositional headaches that resolved within 24 hours (3.1%), 8 increased back pain (2.4%), 2 increased leg pain (0.6%), 4 facial flushing (1.2%), 1 vasovagal reaction (0.3%), 1 increased blood sugar (258mg/dL) in an insulin-dependent diabetic (0.3%), and 1 intraoperative hypertension (0.3%). No dural punctures occurred. Conclusions: There were no major complications. The incidence of minor complications was 9.6% per injection. All reactions resolved without morbidity, and no patient required hospitalization. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

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