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Epidural Steroid Injections Associated With a Low Complication Rate

A recent study recognized at the International Spine Intervention Society Annual Meeting has found clear evidence that transforaminal and interlaminar epidural steroid injections may be performed safely with low risk of complications to patients. According a report by Healio.com, Dr. Christine El-Yahchouchi reviewed more than 16,000 cases at the Mayo Clinic and others to come up with the findings.

A study showing transforaminal and interlaminar epidural steroid injections are beneficial and result in few complications was recognized with the Best Resident Abstract Award at the International Spine Intervention Society Annual Meeting.

Christine El-Yahchouchi, MD, presented the study, which included 16,638 consecutive transforaminal epidural steroid injection (TFESI) or interlaminar epidural steroid injection (ILESI) spine segment procedures.

“Note that we had no major complications,” El-Yahchouchi said.

She and colleagues recorded the complications from the spine segment injections in patients at the centers that participated in the study, which were the Mayo Clinic, the Rehabilitation Institute of Chicago, and the University of Pennsylvania Penn Spine Center.

She said 14,956 patients received TFESI and 1,682 patients received ILESI in the study, which were associated with no neurologic injury, no hemorrhagic complications and no infections, however 1.3% of TFESI patients and 0.5% of ILESI patients had a vasovagal reaction.

 “In conclusion, both transforaminal and interlaminar epidural steroid injections can be safely performed when done in accordance with ISIS (International Spine Intervention Society) guidelines. We had no major complications in 16,638 procedures, only minor complications occurred,” El-Yahchouchi said.

When there is no difference in safety, technique choice should be based on efficacy and effectiveness data, which greatly favors transforaminal epidurals for radicular pain, she said. 

Reference: El-Yahchouchi C. Complication rates of transforaminal and interlaminar epidural steroid injections: A multi-institutional study. Presented at: International Spine Intervention Society Annual Meeting; July 30-Aug. 3, 2014; Orlando, Fla.

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