Neurological Complications Associated with Epidural Steroid Injections

Author:

Manchikanti Laxmaiah,Hirsch Joshua A.

Publisher

Springer Science and Business Media LLC

Subject

Anesthesiology and Pain Medicine,Clinical Neurology,General Medicine

Reference98 articles.

1. US Food and Drug Administration. Drug Safety Communications. FDA drug safety communication: FDA requires label changes to warn of rare but serious neurologic problems after epidural corticosteroid injections for pain. www.fda.gov/downloads/Drugs/DrugSafety/UCM394286.pdf .

2. Manchikanti L, Candido KD, Singh V, Gharibo CG, Boswell MV, Benyamin RM, et al. Epidural steroid warning controversy still dogging FDA. Pain Physician. 2014;17:E451–74. This comprehensive review of the epidural steroid warning controversy describes the prevalence of neurological complications mainly with cervical transforaminal epidural injections and occasionally with lumbar transforaminal epidural injections. The manuscript also describes the efficacy and complications of epidural injections by various modes of administration with interlaminar epidural injections as well as caudal epidural injections.

3. Food and Drug Administration. Anesthetic and Analgesic Drug Products Advisory Committee Meeting. November 24–25, 2014. Epidural steroid injections (ESI) and the risk of serious neurologic adverse reactions. www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AnestheticAndAnalgesicDrugProductsAdvisoryCommittee/UCM422692.pdf .

4. Manchikanti L, Falco FJE, Benyamin RM, Gharibo CG, Candido KD, Hirsch JA. Epidural steroid injections safety recommendations by the Multi-Society Pain Workgroup (MPW): more regulations without evidence or clarification. Pain Physician. 2014;17:E575–88.

5. Engel A, King W, MacVicar J. Standards Division of the International Spine Intervention Society. The effectiveness and risks of fluoroscopically guided cervical transforaminal injections of steroids: a systematic review with comprehensive analysis of the published data. Pain Med. 2014;15:386–402. In this comprehensive manuscript the effectiveness and risks of fluoroscopically guided cervical transforaminal injections of steroids is discussed with a systematic review and comprehensive analysis of the published data. The manuscript reports a lack of proven efficacy of cervical transforaminal epidural injections and a clear and high risk of injection of the particulate steroids with a cervical transforaminal approach.

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