The effectiveness of lumbar interlaminar epidural injections in managing chronic low back and lower extremity pain

Pain Physician

Volumn 15, Issue 4, 2012, Pages

  Benyamin, Ramsin M ^a,b   Manchikanti, Laxmaiah ^c,d   Parr, Allan T ^e   Diwan, Sudhir ^f   Singh, Vijay ^g   Falco, Frank J E ^h,i   Datta, Sukdeb ^j   Abdi, Salahadin ^k,l   Hirsch, Joshua A ^m  

^a MILLENNIUM PAIN CENTER   (United States)

^b UNIVERSITY OF ILLINOIS AT URBANA CHAMPAIGN   (United States)

^c PAIN MANAGEMENT CENTER OF PADUCAH   (United States)

^d UNIVERSITY OF LOUISVILLE   (United States)

^e Premier Pain Center   (United States)

^f The Spine and Pain Institute of New York   (United States)

^g Spine Pain Diagnostics Associates   (United States)

^h Mid Atlantic Spine and Pain Physicians   (United States)

ⁱ TEMPLE UNIVERSITY HOSPITAL   (United States)

^j Laser Spine and Pain Institute   (United States)

^k BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

^l HARVARD MEDICAL SCHOOL   (United States)

^m MASSACHUSETTS GENERAL HOSPITAL   (United States)

more..

Author keywords

Chronic low back pain; Disc herniation; Discogenic pain; Fluoroscopy; Lower extremity pain; Lumbar interlaminar epidural injections; Radiculitis; Spinal stenosis

Indexed keywords

BETAMETHASONE; BUPIVACAINE; DEXAMETHASONE; HYDROCORTISONE; KETAMINE; LIDOCAINE; LOCAL ANESTHETIC AGENT; METHYLPREDNISOLONE; METHYLPREDNISOLONE ACETATE; NARCOTIC ANALGESIC AGENT; PROCAINE; STEROID; TRIAMCINOLONE; TRIAMCINOLONE ACETONIDE;

AVASCULAR NECROSIS; BLEEDING; CHORIORETINOPATHY; CHRONIC PAIN; CORTICOSTEROID INDUCED MYOPATHY; CORTICOSTEROID INDUCED OSTEOPOROSIS; CUSHING SYNDROME; DISCOGENIC PAIN; DISKITIS; EPIDURAL ABSCESS; EPIDURAL HEMATOMA; FLUID RETENTION; FLUOROSCOPY; FLUSHING; FUNCTIONAL STATUS; GAS EMBOLISM; HICCUP; HUMAN; HYPERCORTISOLISM; HYPERGLYCEMIA; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM; INFECTION; INTERVERTEBRAL DISK HERNIA; LEG PAIN; LIPOMATOSIS; LOW BACK PAIN; LUMBAR SPINE; MENINGITIS; MENTAL HEALTH; NERVE ROOT IRRITATION; NERVOUS SYSTEM INJURY; NEUROPATHY; OSTEOMYELITIS; PAIN; PNEUMOCEPHALUS; POSTDURAL PUNCTURE HEADACHE; RADICULITIS; RANDOMIZED CONTROLLED TRIAL (TOPIC); RETINA NECROSIS; REVIEW; SEIZURE; SIDE EFFECT; SYSTEMATIC REVIEW; TRANSITIONAL BLINDNESS; VERTEBRAL CANAL STENOSIS; WEIGHT GAIN; WORK RESUMPTION;

ADRENAL CORTEX HORMONES; ADULT; ANESTHETICS, LOCAL; CHRONIC PAIN; CLINICAL TRIALS AS TOPIC; HUMANS; INJECTIONS, EPIDURAL; LEG; LOW BACK PAIN; LUMBOSACRAL REGION;

EID: 84861910273     PISSN: 15333159     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (300)

1. Manchikanti L, Boswell MV, Singh V, Benyamin RM, Fellows B, Abdi S, Buenaventura RM, Conn A, Datta S, Derby R, Falco FJE, Erhart S, Diwan S, Hayek SM, Helm S, Parr AT, Schultz DM, Smith HS, Wolfer LR, Hirsch JA. Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician 2009; 12:699-802.
2. Freburger JK, Holmes GM, Agans RP, Jackman AM, Darter JD, Wallace AS, Castel LD, Kalsbeek WD, Carey TS. The rising prevalence of chronic low back pain. Arch Intern Med 2009; 169:251-258.
3. Bressler HB, Keyes WJ, Rochon PA, Badley E. The prevalence of low back pain in the elderly. A systematic review of the literature. Spine (Phila Pa 1976) 1999; 24:1813-1819.
4. Ivanova JI, Birnbaum HG, Schiller M, Kantor E, Johnstone BM, Swindle RW. Real-world practice patterns, healthcareutilization, and costs in patientswith low back pain: The long road to guideline-concordant care. Spine J 2011; 11: 622-632.
5. Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: A meta-analysis. Am J Epidemiol 2010; 171:135-154.
6. Macfarlane GJ, Beasley M, Jones EA, Prescott GJ, Docking R, Keeley P, McBeth J, Jones GT; on behalf of the MUSICIAN study team. The prevalence and management of low back pain across adulthood: Results from a population-based crosssectional study (the MUSICIAN study). Pain 2012; 153: 27-32.
7. Cassidy JD, Carroll LJ, Cotê P. The Saskatchewan Health and Back Pain Survey. The prevalence of low back pain and related disability in Saskatchewan Adults. Spine (Phila Pa 1976) 1998; 23:1860-1867.
8. Verhaak PF, Kerssens JJ, Dekker J, Sorbi MJ, Bensing JM. Prevalence of chronic benign pain disorder among adults: A review of the literature. Pain 1998; 77:231-239.
9. Luo X, Pietrobon R, Sun SX, Liu GG, Hey L. Estimates and patterns of directhealth care expenditures among individuals with back pain in the United States. Spine (Phila Pa 1976) 2004; 29:79-86.
10. Walker BF, Muller R, Grant WD. Low back pain in Australian adults: The economicburden. Asia Pac J Public Health 2003; 15:79-87.
11. Deyo RA, Mirza SK, Turner JA, Martin BI. Over treating chronic back pain: Time to back off? J Am Board Fam Med 2009; 22:62-68.
12. Manchikanti L, Pampati V, Boswell MV, Smith HS, Hirsch JA. Analysis of the growth of epidural injections and costs in the Medicare population: A comparative evaluation of 1997, 2002, and 2006 data. Pain Physician 2010; 13:199-212.
13. Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for chronic low-back pain: An update of a Cochrane review. Spine (Phila Pa 1976) 2011; 36:E825-E846.
14. Chou R, Qaseem A, Owens DK, Shekelle P; Clinical Guidelines Committee ofthe American College of Physicians. Diagnostic imaging for low back pain: Advice for high-value health care from the American College of Physicians. Ann In tern Med 2011; 154:181-189.
15. Staal JB, de Bie RA, de Vet HC, Hildebrandt J, Nelemans P. Injection therapy for subacute and chronic low back pain: An updated Cochrane review. Spine (Phila Pa 1976) 2009; 34:49-59.
16. Kovacs FM, Urrútia G, Alarcón JD. Surgery versus conservative treatment for symptomatic lumbar spinal stenosis: A systematic review of randomized controlled trials. Spine (Phila Pa 1976) 2011; 36:E1335-E1351.
17. Jacobs WC, van Tulder M, Arts M, Rubinstein SM, van Middelkoop M, Ostelo R, Verhagen A, Koes B, Peul WC. Surgery versus conservative management of sciatica due to a lumbar herniated disc: A systematic review. Eur Spine J 2011; 20:513-522.
18. Baras JD, Baker LC. Magnetic resonance imaging and low back pain care forMedicare patients. Health Aff (Millwood) 2009; 28:w1133-w1140.
19. Chou R, Huffman L. Use of Chronic Opioid Therapy in Chronic Noncancer Pain: Evidence Review. American Pain Society, Glenview, IL, 2009.ww.ampainsoc.org/pub/pdf/Opioid_Final_Evidence_Report.pdf
20. Chou R, Huffman L. Guideline for the Evaluation and Management of Low Back Pain: Evidence Review. American Pain Society, Glenview, IL, 2009. www.ampainsoc.org/pub/pdf/LBPEvidRev.pdf
21. Manchikanti L, Fellows B, Ailinani H, Pampati V. Therapeutic use, abuse, and nonmedical use of opioids: A ten-year perspective. Pain Physician 2010; 13:401-435.
22. Manchikanti L, Ailinani H, Koyyalagunta D, Datta S, Singh V, Eriator I, Sehgal N, Shah RV, Benyamin RM, Vallejo R, Fellows B, Christo PJ. A systematic review f randomized trials of long- term opioid management for chronic non-cancer pain. Pain Physician 2011; 14:91-121.
23. Manchikanti L, Vallejo R, Manchikanti KN, Benyamin RM, Datta S, Christo PJ. Effectiveness of long-term opioid therapy for chronic non-cancer pain. Pain Physician 2011; 14:E133-E156.
24. Manchikanti L, Pampati V, Singh V, Boswell MV, Smith HS, Hirsch JA. Explosive growth of facet joint interventions in the Medicare population in the United States: A comparative evaluation of 1997, 2002, and 2006 data. BMC Health Serv Res 2010; 10:84.
25. Manchikanti L, Singh V, Caraway DL, Benyamin RM, Hirsch JA. Medicare physician payment systems: Impact of 2011 schedule on interventional pain management. Pain Physician 2011; 14:E5-E33.
26. Bogduk N, Christophidis N, Cherry D. Pidural use of steroids in the management of back pain. Report of working party on epidural use of steroids in the management of back pain. National Health and Medical Research Council, Canberra, Commonwealth of Australia, 1994, pp 1-76.
27. Manchikanti L, Datta S, Derby R, Wolfer LR, Benyamin RM, Hirsch JA. A criticalreview of the American Pain Society clinical practice guidelines for interventional techniques: Part 1. Diagnostic interventions. Pain Physician 2010; 13:E141-E174.
28. Manchikanti L, Datta S, Gupta S, Munglani R, Bryce DA, Ward SP, Benyamin RM, Sharma ML, Helm II S, Fellows B, Hirsch JA. A critical review of the American Pain Society clinical practice guidelines for interventional techniques: Part 2. Therapeutic interventions. Pain Physician 2010; 13:E215-E264.
29. Manchikanti L, Singh V, Boswell MV. Interventional pain management at crossroads: The perfect storm brewing for a new decade of challenges. Pain Physician 2010; 13:E111-E140.
30. Chopko B, Caraway DL. M DAS I (mildff Decompression Alternative to Open Surgery): A preliminary report of a prospective, multi-center clinical study. Pain Physician 2010; 13:369-378.
31. Manchikanti L, Helm II S, Hirsch JA. The evolution of the Patient-Centered Outcome Research Institute. J Neurointervent Surg 2011; Published Online: August 31, 2011.
32. Manchikanti L, Hirsch JA. The Independent Payment Advisory Board: Impact on neurointerventionalists. J Neurointerv Surg 2011; Published Online: October 11, 2011.
33. Manchikanti L, Falco FJE, Boswell MV, Hirsch JA. Facts, fallacies, and politics of comparative effectiveness research: Part 1. Basic considerations. Pain Physician 2010; 13:E23-E54.
34. Manchikanti L, Falco FJE, Boswell MV, Hirsch JA. Facts, fallacies, and politics of comparative effectiveness research: Part 2. Implications for interventional pain management. Pain Physician 2010;13:E55-E79.
35. Manchikanti L, Parr AT, Singh V, Fellows B. Ambulatory surgery centers and interventional techniques: A look at long-term survival. Pain Physician 2011; 14:E177-E215.
36. Manchikanti L, Falco FJ, Benyamin RM, Helm S 2nd, Parr AT, Hirsch JA. The impact of comparative effectiveness research on interventional pain management: Evolution from Medicare Modernization Act to Patient Protection and Affordable Care Act and the Patient- Centered Outcomes Research Institute. Pain Physician 2011; 14:E249-E282.
37. Yi X, McPherson B. Application of XSTOP device in the treatment of lumbarspinal stenosis. Pain Physician 2010; 13:E327-E336.
38. Benyamin RM, Datta S, Falco FJE. A perfect storm in interventional pain management:Regulated, but unbalanced. Pain Physician 2010; 13:109-116.
39. Manchikanti L, Hirsch JA. Medicare physician payment rules for 2011: A primer for the neurointerventionalist. AJNR Am J Neuroradiol 2011; 32:E101-E104.
40. Manchikanti L, Hirsch JA. Medicare physician payment rules for 2011: A primer for the neurointerventionalist. J Neurointervent Surg 2011; 3:399-402.
41. Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, Jarvik JG. Trends, majormedical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA 2010; 303:1259-1265.
42. Chen E, Tong KB, Laouri M. Surgical treatment patterns among Medicare beneficiaries newly diagnosed with lumbar spinal stenosis. Spine J 2010; 10:588-594.
43. Cummins J, Lurie JD, Tosteson TD, Hanscom B, Abdu WA, Birkmeyer NJ, Herkowitz H, Weinstein J. Descriptive epidemiology and prior healthcare utilization of patients in the Spine Patient Outcomes Research Trial's (SPORT) three observational cohorts: Disc herniation,spinal stenosis, and degenerative spondylolisthesis. Spine (Phila Pa 1976) 2006; 31:806-814.
44. Haig AJ, Tomkins CC. Diagnosis and management of lumbar spinal stenosis. JAMA 2010; 303:71-72.
45. Tosteson AN, Tosteson TD, Lurie JD, Abdu W, Herkowitz H, Andersson G, Albert T, Bridwell K, Zhao W, Grove MR, Weinstein MC, Weinstein JN. Comparativeeffectiveness evidence from the spine patient outcomes research trial: Surgical versus nonoperative care for spinal stenosis, degenerative spondylolisthesis, and intervertebral disc herniation. Spine (Phila Pa 1976) 2011; 36: 2061-2068.
46. Parr AT, Diwan S, Abdi S. Lumbar interlaminar epidural injections in managing chronic low back and lower extremity pain: A systematic review. Pain Physician 2009; 12:163-188.
47. Conn A, Buenaventura R, Datta S, Abdi S, Diwan S. Systematic review of caudal epidural injections in the management of chronic low back pain. Pain Physician 2009; 12:109-135.
48. Buenaventura RM, Datta S, Abdi S, Smith HS. Systematic review of therapeutic lumbar transforaminal epidural steroid injections. Pain Physician 2009; 12:233-251.
49. Manchikanti L, Singh V, Derby R, Schultz DM, Benyamin RM, Prager JP, Hirsch JA. Reassessment of evidence synthesis of occupational medicine practice guidelines for interventional pain management. Pain Physician 2008; 11:393-482.
50. Bogduk N. Epidural steroids for low back pain and sciatica. Pain Digest 1999;9:226-227.
51. Kepes ER, Duncalf D. Treatment of backache with spinal injections of localanesthetics, spinal and systemic steroids. Pain 1985; 22:33-47.
52. Koes BW, Scholten RJ, Mens JM, Bouter LM. Efficacy of epidural steroid injections for low back pain and sciatica: A systematic review of randomized clinical trials. Pain 1995; 63:279-288.
53. Koes BW, Scholten RJ, Mens JMA, Bouter LM. Epidural steroid injections for low back pain and sciatica: An updated systematic review of randomized clinical trials. Pain Digest 1999; 9:241-247.
54. Watts RW, Silagy CA. A meta-analysis on the efficacy of epidural corticosteroids in the treatment of sciatica. Anaesth Intensive Care 1995; 23:564-569.
55. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G. Chapter 4: European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006; 15:S192-S300.
56. Armon C, Argoff CE, Samuels J, Backonja MM; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: Use of epidural steroid injections to treat radicular lumbosacral pain: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2007; 68:723-729.
57. Denniston PL. Official Disability Guidelines. 13th ed. Work Loss Data Institute, 2008.
58. American College of Occupational and Environmental Medicine. Low Back Disorders Chapter. In: Occupational Medicine Practice Guidelines: Evaluation and Management of Common Health Problems and Functional Recovery of Workers. Second Edition. American College of Occupational and Environmental Medicine, Elk Grove Village, 2007.
59. Benzon HT. Epidural steroid injections for low back pain and lumbosacral radiculopathy. Pain 1986; 24:277-295.
60. Jensen RK, Leboeuf-Yde C. Is the presence of Modic changes associated with the outcomes of different treatments? A systematic critical review. BMC Musculoskelet Disord 2011; 12:183.
61. Weil L, Frauwirth NH, Amirdelfan K, Grant D, Rosenberg JA. Fluoroscopic analysis of lumbar epidural contrast spread after lumbar interlaminar injection. Arch Phys Med Rehabil 2008; 89:413-416.
62. Alemo S, Sayadipour A. Observational study of the use of an epidurogram in interlaminar lumbar epidural steroid injection. Br J Anaesth 2010; 104:665-666.
63. Cluff R, Mehio AK, Cohen SP, Chang Y, Sang CN, Stojanovic MP. The technical aspects of epidural steroid injections: A national survey. Anesth Analg 2002; 95:403-408.
64. Rathmell JP, Desjardins AE, van der Voort M, Hendriks BH, Nachabe R, Roggeveen S, Babic D, Söderman M, Brynolf M, Holmström B. Identification of the epidural space with optical spectroscopy: An in vivo swine study. Anesthesiology 2010; 113:1406-1418.
65. Choi YK, Barbella JD. Evaluation of epidurographic contrast patterns with fluoroscopic- guided lumbar interlaminar ventral epidural injection. Pain Pract 2009; 9:275-281.
66. White AH, Derby R, Wynne G. Epidural injections for the diagnosis and treatment of low-back pain. Spine (Phila Pa 1976) 1980; 5:78-86.
67. Fredman B, Nun MB, Zohar E, Iraqi G, Shapiro M, Gepstein R, Jedeikin R. Epidural steroids for treating "failed back surgery syndrome": Is fluoroscopy really necessary? Anesth Analg 1999; 88:367-372.
68. Bartynski WS, Grahovac SZ, Rothfus WE. Incorrect needle position during lumbar epidural steroid administration: Inaccuracy of loss of air pressure resistance and requirement of fluoroscopy and epidurography during needle insertion. AJNR Am J Neuroradiol 2005; 26:502-505.
69. Liu SS, Melmed AP, Klos JW, Innis CA. Prospective experience with a 20-gauge Tuohy needle for lumbar epidural steroid injections: Is confirmation withfluoroscopy necessary? Reg Anesth Pain Med 2001; 26:143-146.
70. Whitlock EL, Bridwell KH, Gilula LA. Influence of needle tip position on injectate spread in 406 interlaminar lumbar epidural steroid injections. Radiology 2007; 243:801-811.
71. Rabinovitch DL, Peliowski A, Furlan AD. Influence of lumbar epidural injection volume on pain relief for radicular leg pain and/or low back pain. Spine J 2009; 9:509-517.
72. Candido KD, Raghavendra MS, Chinthagada M, Badiee S, Trepashko DW. A prospective evaluation of iodinated contrast flow patterns with fluoroscopically guided lumbar epidural steroid injections: The lateral parasagittal interlaminar epidural approach versus the transforaminal epidural approach. Anesth Analg 2008; 106:638-644.
73. Botwin KP, Natalicchio J, Hanna A. Fluoroscopic guided lumbar interlaminar epidural injections: A prospective evaluation of epidurography contrast patterns and anatomical review of the epidural space. Pain Physician 2004; 7:77- 80.
74. Lenoir T, Deloin X, Dauzac C, Rillardon L, Guigui P. Paraplegia after interlaminar epidural steroid injection: A case report. Chir Orthop Reparatrice Appar M 2008; 94:697-701.
75. Murthy NS, Maus TP, Behrns CL. Intraforaminal location of the great anterior radiculomedullary artery (artery of Adamkiewicz): A retrospective review. Pain Med 2010; 11:1756-1764.
76. Houten JK, Errico TJ. Paraplegia after lumbosacral nerve root block: Report of three cases. Spine J 2002; 2:70-75.
77. Huntoon MA, Martin DP. Paralysis after transforaminal epidural injection and previous spinal surgery. Reg Anesth Pain Med 2004; 29:494-495.
78. Kennedy DJ, Dreyfuss P, Aprill CN, Bogduk N. Paraplegia following imageguided transforaminal lumbar spine epidural steroid injection: Two case reports. Pain Med 2009; 10:1389-1394.
79. Lyders EM, Morris PP. A case of spinal cord infarction following lumbar transforaminal epidural steroid injection: MR imaging and angiographic findings. Am J Neuroradiol 2009; 30:1691-1693.
80. Somayaji HS, Saifuddin A, Casey AT, Briggs TW. Spinal cord infarction following therapeutic computed tomography- guided left L2 nerve root injection. Spine (Phila Pa 1976) 2005; 30:E106-E108.
81. Wybier M, Gaudart S, Petrover D, Houdart E, Laredo JD. Paraplegia complicating selective steroid injections of the lumbar spine. Report of five cases and review of the literature. Eur Radiol 2010; 20:181-189.
82. Glaser SE, Shah RV. Root cause analysis of paraplegia following transforaminal epidural steroid injections: The "unsafe" triangle. Pain Physician 2010; 13:237-244.
83. Glaser SE, Falco F. Paraplegia following a thoracolumbar transforaminal epidural steroid injection. Pain Physician 2005; 8:309-314.
84. Scanlon GC, Moeller-Bertram T, Romanowsky SM, Wallace MS. Cervical transforaminal epidural steroid injections. More dangerous than we think? Spine (Phila Pa 1976) 2007; 32:1249-1256.
85. Rho ME, Tang CT. The efficacy of lumbar epidural steroid injections: Transforaminal, interlaminar, and caudal approaches. Phys Med Rehabil Clin N Am 2011; 22:139-148.
86. Manchikanti L, Hirsch JA, Smith HS. Evidence- based medicine, systematic reviews, and guidelines in interventional pain management: Part 2: Randomized controlled trials. Pain Physician 2008; 11:717-773.
87. Manchikanti L, Benyamin RM, Helm S, Hirsch JA. Evidence-based medicine, systematic reviews, and guidelines in interventional pain management: Part 3: Systematic reviews and meta-analysis of randomized trials. Pain Physician 2009; 12:35-72.
88. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: The QUOROM statement. Quality of reporting of meta-analyses. Lancet 1999; 354:1896-1900.
89. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Ann Intern Med 2009; 151:W65-W94.
90. van Tulder M, Furlan A, Bombardier C, Bouter L; Editorial Board of the Cochrane Collaboration Back Review Group. Updated method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group. Spine (Phila Pa 1976) 2003; 28:1290-1299.
91. Furlan AD, Pennick V, Bombardier C, van Tulder M; Editorial Board, Cochrane Back Review Group. 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine (Phila Pa 1976) 2009; 34:1929-1941.
92. van Tulder MW, Suttorp M, Morton S, Bouter LM, Shekelle P. Empirical evidence of an association between internal validity and effect size in randomized controlled trials of low-back pain. Spine (Phila Pa 1976) 2009; 34:1685-1692.
93. Manchikanti L, Singh V, Helm S, Schultz DM, Datta S, Hirsch J. An introduction to an evidence-based approach to interventional techniques in the management of chronic spinal pain. Pain Physician 2009; 12:E1-E33.
94. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Metaanalysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000; 283:2008-2012.
95. Parr AT, Manchikanti L, Hameed H, Conn A, Manchikanti KN, Benyamin RM, Diwan S, Singh V, Abdi S. Caudal epidural injections in the management of chronic low back pain: A systematic appraisal of the literature. Pain Physician 2012; 15:E159-E198.
96. Manchikanti L, Buenaventura RM, Manchikanti KN, Ruan X, Gupta S, Smith HS, Christo PJ, Ward SP. Effectiveness of therapeutic lumbar transforaminal epidural steroid injections in managing lumbar spinal pain. Pain Physician 2012; 15:E199-E245.
97. Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, Gøtzsche PC, Lang T; CONSORT GROUP (Consolidated Standards of Reporting Trials). The revised CONSORT statement for reporting randomized trials: Explanation and elaboration. Ann Intern Med 2001; 134:663-694.
98. Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG. CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. BMJ 2010; 340:c869.
99. Moher D, Schulz KF, Altman DG; CONSORT Group (Consolidated Standards of Reporting Trials). The CONSORT statement: Revised recommendations for improving the quality of reports of parallel-group randomized trials. J Am Podiatr Med Assoc 2001; 91:437-442.
100. Moher D, Schulz KF, Altman DG; CONSORT. The CONSORT statement: Revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol 2001; 1:2.
101. Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M, STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration. Ann Intern Med 2007; 147: W163-W194.
102. Staal JB, de Bie R, de Vet HC, Hildebrandt J, Nelemans P. Injection therapy for subacute and chronic low-back pain. Cochrane Database Syst Rev 2008; 3:CD001824.
103. Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. www.ohri.ca/programs/clinical_epidemiology/oxford.asp
104. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327:557-560.
105. Der Simonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7:177-188.
106. Farrar JT. What is clinically meaningful: Outcome measures in pain clinical trials. Clin J Pain 2000; 16:S106-S112.
107. Salaffi F, Stancati A, Silvestri CA, Ciapetti A, Grassi W. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain 2004; 8:283-291.
108. Bombardier C. Outcome assessments in the evaluation of treatment of spinal disorders: Summary and general recommendations. Spine (Phila Pa 1976) 2000; 25:3100-3103
109. Hagg O, Fritzell P, Nordwall A. The clinical importance of changes in outcome scores after treatment for chronic low back pain. Eur Spine J 2003; 12:12-20.
110. Manchikanti L, Cash KA, McManus CD, Pampati V, Benyamin RM. Preliminary results of a randomized, double-blind, controlled trial of fluoroscopic lumbar interlaminar epidural injections in managing chronic lumbar discogenic pain without disc herniation or radiculitis. Pain Physician 2010; 13:E279-E292.
111. Manchikanti L, Singh V, Falco FJE, Cash KA, Pampati V. Evaluation of the effectiveness of lumbar interlaminar epidural injections in managing chronic pain of lumbar disc herniation or radiculitis: A randomized, double-blind, controlled trial. Pain Physician 2010; 13:343-355.
112. Manchikanti L, Cash RA, McManus CD, Pampati V, Fellows B. Fluoroscopic caudal epidural injections with or without steroids in managing pain of lumbar spinal stenosis: One year results of randomized, double-blind, active-controlled trial. J Spinal Disord 2012; 25:226-234.
113. Manchikanti L, Singh V, Cash KA, Pampati V, Damron KS, Boswell MV. A randomized, controlled, double-blind trial of fluoroscopic caudal epidural injections in the treatment of lumbar disc herniation and radiculitis. Spine (Phila Pa 1976) 2011; 36:1897-1905.
114. Manchikanti L, Singh V, Cash KA, Datta S. Management of pain of post lumbar surgery syndrome: One-year results of a randomized, double-blind, active controlled trial of fluoroscopic caudal epidural injections. Pain Physician 2010; 13:509-521.
115. Manchikanti L, Singh V, Falco FJE, Cash KA, Pampati V. Evaluation of lumbar facet joint nerve blocks in managing chronic low back pain: A randomized, doubleblind, controlled trial with a 2-year follow- up. Int J Med Sci 2010; 7:124-135.
116. Manchikanti L, Singh V, Falco FJE, Cash KA, Fellows B. Comparative outcomes of a 2-year follow-up of cervical medial branch blocks in management of chronic neck pain: A randomized, double- blind controlled trial. Pain Physician 2010; 13:437-450.
117. Manchikanti L, Cash KA, Pampati V, Wargo BW, Malla Y. Cervical epidural injections in chronic discogenic neck pain without disc herniation or radiculitis:Preliminary results of a randomized,double-blind, controlled trial. Pain Physician 2010; 13:E265-E278.
118. Manchikanti L, Cash KA, Pampati V, Wargo BW, Malla Y. The effectiveness offluoroscopic cervical interlaminar epidural injections in managing chronic cervical disc herniation and radiculitis: Preliminary results of a randomized, double-blind, controlled trial. Pain Physician 2010; 13:223-236.
119. Manchikanti L, Cash KA, McManus CD, Pampati V, Benyamin RM. A preliminary report of a randomized double-blind, active controlled trial of fluoroscopic thoracic interlaminar epidural injections in managing chronic thoracic pain. Pain Physician 2010; 13:E357-E369.
120. Manchikanti L, Singh V, Falco FJE, Cash KA, Pampati V, Fellows B. Comparative effectiveness of a one-year follow-up of thoracic medial branch blocks in management of chronic thoracic pain: A randomized, double-blind active controlled trial. Pain Physician 2010; 13:535-548.
121. Harbord R, Higgins J. METAREG: Stata module to perform meta-analysis regression. Boston College Department of Economics, Boston, MA. http://econpapers.repec.org/software/bocbocode/s446201.htm
122. SPSS Statistics Software Standard Version (for Windows). Version 9.0.1. Chicago, IL, SPSS Inc; 1999.
123. Huedo-Medina TB, Sánchez-Meca J, Marín-Martínez F, Botella J. Assessing heterogeneity in meta-analysis: Q statistic or I2 index? Psychol Methods 2006; 11:193-206.
124. Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, Atkins D; Methods Work Group, Third US Preventive Services Task Force. Current methods of the US Preventive Services Task Force. Am J Prevent Med 2001; 20:21-35.
125. Serrao JM, Marks RL, Morley SJ, Goodchild CS. Intrathecal midazolam for the treatment of chronic mechanical low back pain: A controlled comparison with epidural steroid in a pilot study. Pain 1992; 48:5-12.
126. Rodriguez Hernandez R, Flores Lopez F. Assessment of pain intensity in patients with diabetic polyneuropathy treated with peridural 2% lidocaine methylprednisolone acetate vs peridural 2% lidocaine. Anestesia en Mexico 1999; 11:65-69.
127. Kikuchi A, Kotani N, Sato T, Takamura K, Sakai I, Matsuki A. Comparative therapeutic evaluation of intrathecal versus epidural methylprednisolone for longterm analgesia in patients with intractable postherpetic neuralgia. Reg Anesth Pain Med 1999; 24:287-293.
128. Buchner M, Zeifang F, Brocai DR, Schiltenwolf M. Epidural corticosteroid injection in the conservative management of sciatica. Clin Orth Rel Res 2000; 375:149-156.
129. McGregor AH, Anjarwalla NK, Stambach T. Does the method of injection alter the outcome of epidural injections? J Spinal Disord 2001; 14:507-510.
130. Dilke TF, Burry HC, Grahame R. Extradural corticosteroid injection in the management of lumbar nerve root compression. Br Med J 1973; 2:635-637.
131. Klenerman L, Greenwood R, Davenport HT, White DC, Peskett S. Lumbar epidural injections in the treatment of sciatica. Br J Rheumatol 1984; 23:35-38.
132. Rocco AG, Frank E, Kaul AF, Lipson SJ, Gallo JP. Epidural steroids, epidural morphine and epidural steroids combined with morphine in the treatment of post-laminectomy syndrome. Pain 1989; 36:297-303.
133. Rogers P, Nash T, Schiller D, Norman J. Epidural steroids for sciatica. Pain Clinic 1992; 5:67-72.
134. Valat JP, Giraudeau B, Rozenberg S, Goupille P, Bourgeois P, Micheau-Beaugendre V, Soubrier M, Richard S, Thomas E. Epidural corticosteroid injections for sciatica: A randomised, double blind, controlled clinical trial. Ann Rheum Dis 2003; 62:639-643.
135. Kraemer J, Ludwig J, Bickert U, Owczarek V, Traupe M. Lumbar epidural perineural injection: A new technique. Eur Spine J 1997; 6:357-361.
136. Pirbudak L, Karakurum G, Oner U, Gulec A, Karadasli H. Epidural corticosteroid injection and amitriptyline for the treatment of chronic low back pain associated with radiculopathy. Pain Clinic 2003; 15:247-253.
137. Bronfort G, Evans RL, Maiers M, Anderson AV. Spinal manipulation, epidural injections, and self-care for sciatica: A pilot study for a randomized clinical trial. J Manipulative Physiol Ther 2004; 278:503-508.
138. Briggs VG, Li W, Kaplan MS, Eskander MS, Franklin PD. Injection treatment and back pain associated with degenerative lumbar spinal stenosis in older adults. Pain Physician 2010 13:E347-E355.
139. Arden NK, Price C, Reading I, Stubbing J, Hazelgrove J, Dunne C, Michel M, Rogers P, Cooper C; WEST Study Group. A multi centre randomized controlled trial of epidural corticosteroid injections for sciatica: The WEST study. Rheumatology (Oxford) 2005; 44:1399-1406.
140. Carette S, Leclaire R, Marcoux S, Morin F, Blaise GA, St-Pierre A, Truchon R, Parent F, Levesque J, Bergeron V, Montminy P, Blanchette C. Epidural corticosteroid injections for sciatica due to herniated nucleus pulposus. N Engl J Med 1997; 336:1634-1640.
141. Cuckler JM, Bernini PA, Wiesel SW, Booth RE Jr, Rothman RH, Pickens GT. The use of epidural steroid in the treatment of radicular pain. J Bone Joint Surg 1985; 67:63-66.
142. Wilson-MacDonald J, Burt G, Griffin D, Glynn C. Epidural steroid injection for nerve root compression: A randomized, controlled trial. J Bone Joint Surg Br 2005; 87-B:352-355.
143. Snoek W, Weber H, Jorgensen B. Double- blind evaluation of extradural methylprednisolone for herniated lumbar disc. Acta Orthop Scand 1977; 48:635-641.
144. Ridley MG, Kingsley GH, Gibson T, Grahame R. Outpatient lumbar epidural corticosteroid injection in the management of sciatica. Br J Rheumatol 1988; 27:295-299.
145. Buttermann GR. The effect of spinal steroid injections for degenerative disc disease. Spine J 2004; 4:495-505.
146. Campbell MJ, Carreon LY, Glassman SD, McGinnis MD, Elmlinger BS. Correlation of spinal canal dimensions to efficacy of epidural steroid injection in spinal stenosis. J Spinal Disord Tech 2007; 20:168-171.
147. Manchikanti L, Cash KA, McManus CD, Damron KS, Pampati V, Falco FJE. Lumbar interlaminar epidural injections in central spinal stenosis: Preliminary results of a randomized double-blind control trial. Pain Physician 2012; 15:51-63.
148. Jirarattanaphochai K, Jung S, Thienthong S, Krisanaprakornkit W, Sumananont C. Peridural methylprednisolone and wound infiltration with bupivacaine for postoperative pain control after posterior lumbar spine surgery: A randomized double-blinded placebo-controlled trial. Spine (Phila Pa 1976) 2007; 32:609-616.
149. Schaufele MK, Hatch L, Jones W. Interlaminar versus transforaminal epidural injections for the treatment of symptomatic lumbar intervertebral disc herniations. Pain Physician 2006; 9:361-366.
150. Price CM, Rogers PD, Prosser AS, Arden NK. Comparison of the caudal and lumbar approaches to the epidural space. Ann Rheum Dis 2000; 59:879-882.
151. Kapural L, Mekhail N, Bena J, McLain R, Tetzlaff J, Kapural M, Mekhail M, Polk S. Value of the magnetic resonance imaging in patients with painful lumbar spinal stenosis (LSS) undergoing lumbar epidural steroid injections. Clin J Pain 2007; 23:571-575.
152. Rivest C, Katz JN, Ferrante M, Jamison RN. Effects of epidural steroid injection on pain due to lumbar spinal stenosis or herniated disks: A prospective study. Arthritis Care Res 1998; 11:291-297.
153. Fukusaki M, Kobayashi I, Hara T, Sumikawa K. Symptoms of spinal stenosis do not improve after epidural steroid injection. Clin J Pain 1998; 14:148-151.
154. Bush K, Cowan N, Katz DE, Gishen P. The natural history of sciatica associated with disc pathology. A prospective study with clinical and independent radiologic follow-up. Spine (Phila Pa 1976) 1992; 17:1205-1212.
155. Power RA, Taylor GJ, Fyfe IS. Lumbar epidural injection of steroid in acute prolapsed intervertebral discs. A prospective study. Spine (Phila Pa 1976) 1992; 17:453-455.
156. Berman AT, Garbarino JL Jr, Fisher SM, Bosacco SJ. The effects of epidural injection of local anesthetics and corticosteroids on patients with lumbosciatic pain. Clin Orthop Relat Res 1984; 188:144-151.
157. Bowman SJ, Wedderburn L, Whaley A, Grahame R, Newman S. Outcome assessment after epidural corticosteroid injection for low back pain and sciatica. Spine (Phila Pa 1976) 1993; 18:1345-1350.
158. Hopwood MB, Abram SE. Factors associated with failure of lumbar epidural steroids. Reg Anesth 1993; 18:238-243.
159. Koning HM, Koning AJ, Bruinen TCM, Koster HG, Heybroek E. The period of pain relief following a successful epidural steroid injection for low-back pain. Pain Clin 2002; 13:331-338.
160. Nawani DP, Agrawal S, Asthana V. Single shot epidural injection for cervical and lumbosaccral radiculopathies: A preliminary study. Korean J Pain 2010; 23:254-257.
161. Lotfinia I, Khallaghi E, Meshkini A, Shakeri M, Shima M, Safaeian A. Interaoperative use of epidural methylprednisolone or bupivacaine for postsurgical lumbar discectomy pain relief: A randomized, placebo-controlled trial. Ann Saudi Med 2007; 27:279-283.
162. Rasmussen S, Krum-Møller DS, Lauridsen LR, Jensen SE, Mandøe H, Gerlif C, Kehlet H. Epidural steroid following discectomy for herniated lumbar disc reduces neurological impairment and enhances recovery: A randomized study with two-year follow-up. Spine (Phila Pa 1976) 2008; 33:2028-2033.
163. Mitra R, Huang L, Payne C. Epidural steroid injections in the management of a patient with spinal stenosis and urinary urgency. Nat Clin Pract Urol 2009; 6:113-115.
164. Stretanski MF. H-reflex latency and nerve root tension sign correlation in fluoroscopically guided, contrast-confirmed, translaminar lumbar epidural steroid-bupivacaine injections. Arch Phys Med Rehabil 2004; 85:1479-1482.
165. Lee JH, An JH, Lee SH. Comparison of the effectiveness of interlaminar and bilateral transforaminal epidural steroid injections in treatment of patients withlumbosacral disc herniation and spinal stenosis. Clin J Pain 2009; 25:206-210.
166. Nagda JV, Davis CW, Bajwa ZH, Simopoulos TT. Retrospective review of the efficacy and safety of repeated pulsed and continuous radiofrequency lesioning of the dorsal root ganglion/segmental nerve for lumbar radicular pain. Pain Physician 2011; 14:371-376.
167. Lima RM, Navarro LH, Carness JM, Barros GA, Marques ME, Solanki D, Ganem EM. Clinical and histological effects of the intrathecal administration of methylprednisolone in dogs. Pain Physician 2010; 13:493-501.
168. Park CH, Lee SH, Jung JY. Dural sac cross-sectional area does not correlate with efficacy of percutaneous adhesiolysis in single level lumbar spinal stenosis. Pain Physician 2011; 14:377-382.
169. Price C, Arden N, Coglan L, Rogers P. Cost-effectiveness and safety of epidural steroids in the management of sciatica. Health Technol Assess 2005; 9:1-58.
170. Debi R, Halperin N, Mirovsky Y. Local application of steroids following lumbar discectomy. J Spinal Disord Tech 2002; 15:273-276.
171. Aldrete JA. Epidural injections of indomethacin for postlaminectomy syndrome: A preliminary report. Anesth Analg 2003; 96:463-468.
172. Furman MB, Kothari G, Parikh T, Anderson JG, Khawaja A. Efficacy of fluoroscopically guided, contrast-enhanced lumbosacral interlaminar epidural steroid injections: A pilot study. Pain Med 2010; 11:1328-1334.
173. Smith CC, Booker T, Schaufele MK, Weiss P. Interlaminar versus transforaminal epidural steroid injections for the treatment of symptomatic lumbar spinal stenosis. Pain Med 2010; 11:1511-1515.
174. Rados I, Sakic K, Fingler M, Kapural L. Efficacy of interlaminar vs transforaminal epidural steroid injection for the treatment of chronic unilateral radicular pain: Prospective, randomized study. Pain Med 2011; 12:1316-1321.
175. Noe CE, Haynsworth RF Jr. Comparison of epidural Depo-Medrol vs. aqueous betamethasone in patients with low back pain. Pain Pract 2003; 3:222-225.
176. Buttermann GR. Lumbar disc herniation regression after successful epidural steroid injection. J Spinal Disord Tech 2002; 15:469-476.
177. Buttermann GR. Treatment of lumbar disc herniation: Epidural steroid injection compared with discectomy. A prospective, randomized study. J Bone Joint Surg Am 2004; 86-A: 670-679.
178. Lee JH, Moon J, Lee SH. Comparison of effectiveness according to different approaches of epidural steroid injection in lumbosacral herniated disk and spinal stenosis. J Back Musculoskelet Rehabil 2009; 22:83-89.
179. Kim D, Brown J. Efficacy and safety of lumbar epidural dexamethasone versus methylprednisolone in the treatment of lumbar radiculopathy: A comparison of soluble versus particulate steroids. Clin J Pain 2011; 27:518-522.
180. Amr YM. Effect of addition of epidural ketamine to steroid in lumbar radiculitis: One-year follow-up. Pain Physician 2011; 14:475-481.
181. Ackerman WE 3rd, Ahmad M. The efficacy of lumbar epidural steroid injections in patients with lumbar disc herniations. Anesth Analg 2007; 104:1217-1222.
182. Lee JW, Shin HI, Park SY, Lee GY, Kang HS. Therapeutic trial of fluoroscopic interlaminar epidural steroid injection for axial low back pain: Effectiveness and outcome predictors. AJNR Am J Neuroradiol 2010; 31:1817-1823.
183. Gharibo CG, Varlotta GP, Rhame EE, Liu EC, Bendo JA, Perloff MD. Interlaminar versus transforaminal epidural steroids for the treatment of subacute lumbar radicular pain: A randomized, blinded, prospective outcome study. Pain Physician 2011; 14:499-511.
184. Gelalis ID, Arnaoutoglou E, Pakos EE, Politis AN, Rapti M, Xenakis TA, Papadopoulos G. Effect of interlaminar epidural steroid injection in acute and subacute pain due to lumbar disk herniation: A randomized comparison of 2 different protocols. Open Orthop J 2009; 3:121-124.
185. Heyse-Moore GH. A rational approach to the use of epidural medication in the treatment of sciatic pain. Acta Orthop Scand 1978; 49:366-370.
186. Jamison RN, VadeBoncouer T, Ferrante FM. Low back pain patients unresponsive to an epidural steroid injection: Identifying predictive factors. Clin J Pain 1991; 7:311-317.
187. Manchikanti L, Pakanati RR, Pampati V. Comparison of three routes of epidural steroid injections in low back pain. Pain Digest 1999; 9:277-285.
188. Evansa I, Vasilevskis E, Vanags I, Logina I, Borgeat A. Outcomes of lumbar epidural steroid injections - A cohort study. Periodicum Biologorum 2011; 113 Suppl 1:27.
189. Prochazka J, Hejcl A, Prochazkova L. Intrathecal midazolam as supplementary analgesia for chronic lumbar pain- 15 years' experience. Pain Med 2011; 12:1309-1315.
190. Sangheli M, Plesca S, Chetrari L. The role of epidural steroid injections in patients with multilevel lumbosacral herniated nucleus pulposus. Eur J Pain Supple 2011; 5:290.
191. Dureja GP, Usmani H, Khan M, Tahseen M, Jamal A. Efficacy of intrathecal midazolam with or without epidural methylprednisolone for management of postherpetic neuralgia involving lumbosacral dermatomes. Pain Physician 2010; 13:213-221.
192. Möller JC, Cron RQ, Young DW, Girschick HJ, Levy DM, Sherry DD, Kukita A, Saijo K, Pessler F. Corticosteroidinduced spinal epidural lipomatosis in the pediatric age group: Report of a new case and updated analysis of the literature. Pediatr Rheumatol Online J 2011; 9:5.
193. Kapoor R, Liu J, Devasenapathy A, Gordin V. Gadolinium encephalopathy after intrathecal gadolinium injection. Pain Physician 2010; 13:E321-E326.
194. Koc Z, Ozcakir S, Sivrioglu K, Gurbet A, Kucukoglu S. Effectiveness of physical therapy and epidural steroid injections in lumbar spinal stenosis. Spine (Phila Pa 1976) 2009; 34:985-989.
195. Rosen CD, Kahanovitz N, Bernstein R, Viola K. A retrospective analysis of the efficacy of epidural steroid injections. Clin Orthop Relat Res 1988; 228:270-272.
196. Wang JC, Lin E, Brodke DS, Youssef JA. Epidural injections for the treatment of symptomatic lumbar herniated discs. J Spinal Disord Tech 2002; 15:269-272.
197. Mobaleghi J, Allahdini F, Nasseri K, Ahsan B, Shami S, Faizi M, Gharibi F. Comparing the effects of epidural methylprednisolone acetate injected in patients with pain due to lumbar spinal stenosis or herniated disks: A prospective study. Int J Gen Med 2011; 4:875-878.
198. Manchikanti L, Cash KA, McManus CD, Pampati V, Benyamin RM. Fluoroscopic lumbar interlaminar epidural injections in managing chronic lumbar axial or discogenic pain. J Pain Research 2012; in press.
199. Manchikanti L, Cash KA, McManus CD, Pampati V, Benyamin RM. Chronic pain of lumbar disc herniation or radiculitis: The role of fluoroscopic epidural injections. Pain Res Treat 2012; in submission.
200. Gutknecht DR. Chemical meningitis following epidural injections of corticosteroids (Letter). Am J Med 1987; 82:570.
201. Yue WM, Tan SB. Distant skip level discitis and vertebral osteomyelitis after caudal epidural injection: A case report of a rare complication of epidural injections. Spine (Phila Pa 1976) 2003; 28:E209-E211.
202. Kabbara A, Rosenberg SK, Untal C. Methicillin-resistant staphylococcus aureus epidural abscess after transforaminal epidural steroid injection. Pain Physician 2004; 7:269-272.
203. Hooten WM, Kinney MO, Huntoon MA. Epidural abscess and meningitis after epidural corticosteroid injection. Mayo Clin Proc 2004; 79:682-686.
204. Manchikanti L, Malla Y, Wargo BW, Fellows B. Infection control practices (safe injection and medication vial utilization) for interventional techniques: Are they based on relative risk management or evidence? Pain Physician 2011; 14:425-434.
205. Simopoulos TT, Kraemer JJ, Glazer P, Bajwa ZH. Vertebral osteomyelitis: A potentially catastrophic outcome after lumbar epidural steroid injection. Pain Physician 2008; 11:693-697.
206. McGrath JM, Schaefer MP, Malkamaki DM. Incidence and characteristics of complications from epidural steroid injections. Pain Med 2011; 12:726-731.
207. Coumans JV, Walcott BP. Rapidly progressive lumbar subdural empyema following acromial bursal injection. J ClinNeurosci 2011; 18:1562-1563.
208. Saigal G, Donovan Post MJ, Kozic D. Thoracic intradural Aspergillus abscess formation following epidural steroid injection. AJNR Am J Neuroradiol 2004; 25:642-644.
209. Torres-Ramos FM, Botwin K, Shah CP. Candida spondylodiscitis: An unusual case of thoracolumbar pain with review of imaging findings and description of the clinical condition. Pain Physician 2004; 7:257-260.
210. Ozdemir O, Calisaneller T, Yildirim E, Altinors N. Acute intracranial subdural hematoma after epidural steroid injection: A case report. J Manipulative Physiol Ther 2007; 30:536-538.
211. Yoo HS, Park SW, Han JH, Chung JY, Yi JW, Kang JM, Lee BJ, Kim DO. Paraplegia caused by an epidural hematoma in a patient with unrecognized chronic idiopathic thrombocytopenic purpura following an epidural steroid injection. Spine (Phila Pa 1976) 2009; 34:E376-E379.
212. Xu R, Bydon M, Gokaslan ZL, Wolinsky JP, Witham TF, Bydon A. Epidural steroid injection resulting in epidural hematoma in a patient despite strict adherence to anticoagulation guidelines. J Neurosurg Spine 2009; 11:358-364.
213. Shanthanna H, Park J. Acute epidural haematoma following epidural steroid injection in a patient with spinal stenosis. Anaesthesia 2011; 66:837-839.
214. La Ban MM, Kasturi G, Wang IM. Epidural corticosteroid injections precipitating epidural hematomas with spinalparesis. Am J Phys Med Rehabil 2007; 86:166-167.
215. Ain RJ, Vance MB. Epidural hematoma after epidural steroid injection in a patient withholding enoxaparin per guidelines. Anesthesiology 2005; 102:701-703.
216. Manchikanti L, Malla Y, Wargo BW, Cash KA, McManus CD, Damron KS, Jackson SD, Pampati V, Fellows B. A prospective evaluation of bleeding risk of interventional techniques in chronic pain. Pain Physician 2011; 14:317-329.
217. Nelson DA, Landau WM. Intraspinal steroids: History, efficacy, accidentality, and controversy with review of United States Food and Drug Administration reports. J Neurol Neurosurg Psychiatry 2001; 70:433-443.
218. Manchikanti L, Singh V. Corticosteroids. In: Manchikanti L, Christo PJ, Trescot AM, Falco FJE (eds). Foundations of Pain Medicine and Interventional Pain Management: A Comprehensive Review. ASIPP Publishing, Paducah, KY, 2011, pp 589-606.
219. Delaney TJ, Rowlingson JC, Carron H, Butler A. Epidural steroid effects on nerves and meninges. Anesth Analg 1980; 58:610-614.
220. Abram SE, Marsala M, Yaksh TL. Analgesic and neurotoxic effects of intrathecal corticosteroids in rats. Anesthesiology 1994; 81:1198-1205.
221. Chino N, Awad EA, Kottke FJ. Pathology of propylene glycol administered by perineural and intramuscular injection in rats. Arch Phys Med Rehab 1974; 55:33-38.
222. Latham JM, Fraser RD, Moore RJ, Blumbergs PC, Bogduk N. The pathologic effects of intrathecal betamethasone. Spine (Phila Pa 1976) 1997; 22:1558-1562.
223. Linn AJ, Desilva C, Peeters-Asdourian C. Thromboembolic stroke: A rare complication associated with peri-procedural management of an epidural steroid injection. Pain Physician 2009; 12:159-162.
224. Usta B, Muslu B. Sedation during cervical vs. lumbar translaminar epidural steroid injections. Pain Pract 2009; 9:480; author reply 480-481.
225. Thefenne L, Dubecq C, Zing E, Rogez D, Soula M, Escobar E, Defuentes G, Lapeyre E, Berets O. A rare case of paraplegia complicating a lumbar epidural infiltration. Ann Phys Rehabil Med 2010; 53:575-583.
226. Benzon HT, Iqbal M, Tallman MS, Boehlke L, Russell EJ. Superior sagittal sinus thrombosis in a patient with postdural puncture headache. Reg Anesth Pain Med 2003; 28:64-67.
227. Hetts SW, Narvid J, Singh T, Meagher S, Corcoran K, Higashida RT, Dowd CF, Halbach VV. Association between lumbar epidural injection and development of acute paraparesis in patients with spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 2007; 28:581-583.
228. Schultz TE. Inadvertent discogram during epidural steroid injection: A case report. AANA J 2008; 76:189-191.
229. Candido KD, Katz JA, Chinthagada M, McCarthy RA, Knezevic NN. Incidence of intradiscal injection during lumbar fluoroscopically guided transforaminal and interlaminar epidural steroid injections. Anesth Analg 2010; 110:1464-1467.
230. Ammirati M, Perino F. Symptomatic air trapped in the spine after lumbar epidural corticosteroid injection. Case report. J Neurosurg Spine 2006; 5:359-361.
231. Lehmann LJ, Pallares VS. Subdural injection of a local anesthetic with steroids: Complication of epidural anesthesia. South Med J 1995; 88:467-469.
232. Purdy EP, Ajimal GS. Vision loss after lumbar epidural steroid injection. Anesth Analg 1998; 86:119-122.
233. Huang J, Kwa A. Lumbar discogram resulting from lumbar interlaminar epidural injection. J Clin Anesth 2004; 16:296-298.
234. Young WF. Transient blindness after lumbar epidural steroid injection: A case report and literature review. Spine (Phila Pa 1976) 2002; 27:E476-E477.
235. Browning DJ. Acute retinal necrosis followingepidural steroid injections. Am J Ophthalmol 2003; 136:192-194.
236. Kusher FH, Olson JC. Retinal hemorrhage as a consequence of epidural steroid injection. Arch Opthalmol 1995; 113:309-313.
237. Iida T, Spaide RF, Negrao SG, Carvalho CA, Yannuzzi LA. Central serous chorioretinopathy after epidural corticosteroid injection. Am J Ophthalmol 2001; 132:423-425.
238. Pizzimenti JJ, Daniel KP. Central serous chorioretinopathy after epidural steroids. Pharmacotherapy 2005; 25:1141-1146.
239. McAllister RK, McDavid AJ, Meyer TA, Bittenbinder TM. Recurrent persistent hiccups after epidural steroid injection and analgesia with bupivacaine. Anesth Analg 2005; 100:1834-1836.
240. Everett CR, Baskin MN, Novoseletsky D, Speach D, Patel R. Flushing as a side effect following lumbar transforaminal epidural steroid injection. Pain Physician 2004; 7:427-429.
241. Kim CH, Issa MA, Vaglienti RM. Flushing following interlaminar lumbar epidural steroid injection with dexamethasone. Pain Physician 2010; 13:481-484.
242. Somanchi BV, Mohammad S, Ross R. An unusual complication following caudal epidural steroid injection: A case report. Acta Orthop Belg 2008; 74:720-722.
243. Manchikanti L, Malla Y, Wargo BW, Fellows B. Preoperative fasting before interventional techniques: Is it necessary or evidence-based? Pain Physician 2011; 14:459-467.
244. Mosaffa F, Karimi K, Madadi F, Khoshnevis SH, Besheli LD, Eajazi A. Post-dural puncture headache: A comparisonbetween median and paramedian approaches in orthopedic patients. Anesth Pain 2011; 1:66-69.
245. Gonzalez P, Laker SR, Sullivan W, Harwood JE, Akuthota V. The effects of epidural betamethasone on blood glucose in patients with diabetes mellitus. PM R 2009; 1:340-345.
246. Gitkind AI, Shah B, Thomas M. Epidural corticosteroid injections as a possible cause of menorrhagia: A case report. Pain Med 2010; 11:713-715.
247. Hughes JM, Hichens M, Booze GW, Thorner MO. Cushing's syndromes from therapeutic use of intramuscular dexamethasone acetate. Arch Intern Med 1986; 146:1848-1849.
248. Maillefert JF, Aho S, Piroth-Chatard C, Tavernier C. Cortisol levels after single local steroid injection. Am J Med 1996; 100:586-587.
249. Boonen S, Van Distel G, Westhovens R, Dequeker J. Steroid myopathy induced by epidural triamcinolone injection. Brit J Rheumatol 1995; 34:385.
250. McCullen GM, Spurling GR, Webster JS. Epidural lipomatosis complicating lumbar steroid injections. J Spinal Disord 1999; 12:526-529.
251. Manchikanti L, Malla Y, Wargo BW, Cash KA, Pampati V, Fellows B. A prospective evaluation of complications of 10,000 fluoroscopically directed epidural injections. Pain Physician 2012; 15:131-140.
252. Manchikanti L, Cash KA, Moss TL, Pampati V. Effectiveness of protective measures in reducing risk of radiation exposure in interventional pain management: A prospective evaluation. Pain Physician 2003; 6:301-305.
253. Manchikanti L, Cash KA, Moss TL, Rivera JJ, Pampati V. Risk of whole body radiation exposure and protective measures in fluoroscopically guided interventional techniques: A prospective evaluation. BMC Anesthesiol 2003; 3:2.
254. Manchikanti L, Cash KA, Moss TL, Pampati V. Radiation exposure to the physician in interventional pain management. Pain Physician 2002; 5:385-393.
255. American Society of Anesthesiologists Task Force on Chronic Pain Management; American Society of Regional Anesthesia and Pain Medicine. Practice guidelines for chronic pain management: An updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology 2010; 112:810-833.
256. Mehta M, Salmon N. Extradural block. Confirmation of the injection site by X-ray monitoring. Anaesthesia 1985; 40:1009-1012.
257. Burn JM, Guyer PB, Langdon L. The spread of solutions injected into the epidural space: A study using epidurograms in patients with lumbosciatic syndrome. Br J Anaesth 1973; 45:338-345.
258. Manchikanti L, Bakhit CE, Pakanati RR, Fellows B. Fluoroscopy is medically necessary for the performance of epidural steroids. Anesth Analg 1999; 89:1330-1331.
259. Nishimura N, Khahara T, Kusakabe T. The spread of lidocaine and 1-131 solution in the epidural space. Anesthesiology 1959; 20:785-788.
260. Manchikanti L, Dunbar EE. Correlation of spinal canal dimensions to efficacy of epidural steroid injection in spinal stenosis. J Spinal Disord Tech 2007; 20:546-547.
261. Peterson C, Hodler J. Evidence-based radiology (part 1): Is there sufficient research to support the use of therapeutic injections for the spine and sacroiliac joints? Skeletal Radiol 2010; 39:5-9.
262. Carette S, Marcoux S, Truchon R, Grondin C, Gagnon J, Allard Y, Latulippe M. A controlled trial of corticosteroid injections into facet joints for chronic low back pain. N Engl J Med 1991; 325:1002-1007.
263. Karppinen J, Malmivaara A, Kurunlahti M, Kyllönen E, Pienimäki T, Nieminen P, Ohinmaa A, Tervonen O, Vanharanta H. Periradicular infiltration for sciatica: A randomized controlled trial. Spine (Phila Pa 1976) 2001; 26:1059-1067.
264. Manchikanti L, Giordano J, Fellows B, Hirsch JA. Placebo and nocebo in interventional pain management: A friend or a foe - or simply foes? Pain Physician 2011; 14:E157-E175.
265. Smuck M, Levin JH Manchikanti L, Singh V, Falco FJE, Cash KA, Fellows B. Cervical medial branch blocks for chronic cervical facet joint pain: A randomized double-blind, controlled trial with one-year follow-up. Spine (Phila Pa 1976) 2008; 33:1813-1820. Spine (Phila Pa 1976) 2009; 34:1116-1117.
266. Levin JH. Prospective, double-blind, randomized placebo-controlled trials in interventional spine: What the highest quality literature tells us. Spine J 2009; 9:690-703.
267. Manchikanti L, Shah RV, Datta S, Singh V. Critical evaluation of interventional pain management literature provides inaccurate conclusions. Spine J 2009; 9:706-708.
268. Nelemans PJ, Debie RA, DeVet HC, Sturmans F. Injection therapy for subacute and chronic benign low back pain. Spine (Phila Pa 1976) 2001; 26:501-515.
269. Pham Dang C, Lelong A, Guilley J, Nguyen JM, Volteau C, Venet G, Perrier C, Lejus C, Blanloeil Y. Effect on neurostimulation of injectates used for perineural space expansion before placement of a stimulating catheter: Normal saline versus dextrose 5% in water. Reg Anesth Pain Med 2009; 34:398-403.
270. Tsui BC, Kropelin B, Ganapathy S, Finucane B. Dextrose 5% in water: Fluid medium maintaining electrical stimulation of peripheral nerve during stimulating catheter placement. Acta Anaesthesiol Scand 2005; 49:1562-1565.
271. Indahl A, Kaigle AM, Reikeräs O, Holm SH. Interaction between the porcine lumbar intervertebral disc, zygapophysial joints, and paraspinal muscles. Spine (Phila Pa 1976) 1997; 22:2834-2840.
272. Indahl A, Kaigle A, Reikeräs O, Holm S. Electromyographic response of the porcine multifidus musculature after nerve stimulation. Spine (Phila Pa 1976) 1995; 20:2652-2658.
273. Bhatia MT, Parikh LCJ. Epidural saline therapy in lumbo-sciatic syndrome. J Indian Med Assoc 1966; 47:537-542.
274. Gupta AK, Mital VK, Azmi RU. Observations of the management of lumbosciatic syndromes (sciatica) by epidural saline. J Indian Med Assoc 1970; 54:194-196.
275. Pasqualucci A, Varrassi G, Braschi A, Peduto VA, Brunelli A, Marinangeli F, Gori F, Colò F, Paladini A, Mojoli F. Epidural local anesthetic plus corticosteroid for the treatment of cervical brachial radicular pain: Single injection versus continuous infusion. Clin J Pain 2007; 23:551-557.
276. Byrod G, Otani K, Brisby H, Rydevik B, Olmarker K. Methylprednisolone reduces the early vascular permeability increase in spinal nerve roots induced by epidural nucleus pulposus application. J Orthop Res 2000; 18:983-987.
277. Hayashi N, Weinstein JN, Meller ST, Lee HM, Spratt KF, Gebhart GF. The effect of epidural injection of betamethasone or bupivacaine in a rat model of lumbar radiculopathy. Spine (Phila Pa 1976) 1998; 23:877-885. Pain Physician: July/August 2012; 15:E363-E404 E404 www.painphysicianjournal.com
278. Lee HM, Weinstein JN, Meller ST, Hayashi N, Spratt KF, Gebhart GF. The role of steroids and their effects on phospholipase A2: An animal model of radiculopathy. Spine (Phila Pa 1976) 1998; 23:1191-1196.
279. Minamide A, Tamaki T, Hashizume H, Yoshida M, Kawakami M, Hayashi N. Effects of steroids and lipopolysaccharide on spontaneous resorption of herniated intervertebral discs: An experimental study in the rabbit. Spine (Phila Pa 1976) 1998; 23:870-876.
280. Mao J, Chen LL. Systemic lidocaine for neuropathic pain relief. Pain 2000; 87:7-17.
281. Pasqualucci A. Experimental and clinical studies about the preemptive analgesia with local anesthetics. Possible reasons of the failure. Minerva Anestesiol 1998; 64:445-457.
282. Arner S, Lindblom U, Meyerson BA, Molander C. Prolonged relief of neuralgia after regional anesthetic block. A call for further experimental and systematic clinical studies. Pain 1990; 43:287-297.
283. Lavoie PA, Khazen T, Filion PR. Mechanisms of the inhibition of fast axonal transport by local anesthetics. Neuropharmacology 1989; 28:175-181.
284. Ji RR, Woolf CJ. Neuronal plasticity and signal transduction in no ciceptive neurons: Implications for the initiation and maintenance of pathological pain. Neurobiol Dis 2001; 8:1-10.
285. Cassuto J, Sinclair R, Bonderovic M. Anti- inflammatory properties of local anesthetics and their present and potential clinical implications. Acta Anaesthesiol Scand 2006; 50:265-282.
286. Manchikanti L, Cash KA, McManus CD, Pampati V, Singh V, Benyamin RM. The preliminary results of a comparative effectiveness evaluation of adhesiolysis and caudal epidural injections in managing chronic low back pain secondary to spinal stenosis: A randomized, equivalence controlled trial. Pain Physician 2009; 12:E341-E354.
287. Manchikanti L, Singh V, Cash KA, Pampati V, Datta S. A comparative effectiveness evaluation of percutaneous adhesiolysis and epidural steroid injections in managing lumbar post surgery syndrome: A randomized, equivalence controlled trial. Pain Physician 2009; 12:E355-E368.
288. Manchikanti L, Cash KA, McManus CD, Pampati V, Abdi S. Preliminary results of randomized, equivalence trial of fluoroscopic caudal epidural injections in managing chronic low back pain: Part 4. Spinal stenosis. Pain Physician 2008; 11:833-848.
289. Manchikanti L, Singh V, Cash KA, Pampati V, Damron KS, Boswell MV. Preliminary results of randomized, equivalence trial of fluoroscopic caudal epidural injections in managing chronic low back pain: Part 2. Disc herniation and radiculitis. Pain Physician 2008; 11:801-815.
290. Manchikanti L, Malla Y, Cash KA, McManus CD, Pampati V. Fluoroscopic cervical interlaminar epidural injections in managing chronic pain of cervical postsurgery syndrome: Preliminary results of a randomized, double-blind active control trial. Pain Physician 2012; 15:13-26.
291. Manchikanti L, Malla Y, Cash KA, McManus CD, Pampati V. Fluoroscopic epidural injections in cervical spinal stenosis: Preliminary results of a randomized, double-blind, active control trial. Pain Physician 2012; 15:E59-E70.
292. Manchikanti L, Singh V, Falco FJ, Cash KA, Fellows B. Cervical medial branch blocks for chronic cervical facet joint pain: A randomized double-blind, controlled trial with one-year follow-up. Spine (Phila Pa 1976) 2008; 33:1813-1820.
293. Sato C, Sakai A, Ikeda Y, Suzuki H, Sakamoto A. The prolonged analgesic effect of epidural ropivacaine in a rat model of neuropathic pain. Anesth Analg 2008; 106:313-320.
294. Tachihara H, Sekiguchi M, Kikuchi S, Konno S. Do corticosteroids produce additional benefit in nerve root infiltration for lumbar disc herniation. Spine (Phila Pa 1976) 2008; 33:743-747.
295. Manchikanti L, Datta S, Smith HS, Hirsch JA. Evidence-based medicine, systematic reviews, and guidelines in interventional pain management: Part 6. Systematic reviews and meta-analyses of observational studies. Pain Physician 2009; 12:819-850.
296. Hotopf M. The pragmatic randomized controlled trial. Adv Psychiatr Treat 2002; 8:326-333.
297. Hotopf M, Churchill R, Lewis G. Pragmatic randomized controlled trials in psychiatry. Br J Psychiatry 1999; 175: 217-223.
298. Tunis SR, Stryer DB, Clancy CM. Practical clinical trials Increasing the value of clinical research for decision making in clinical and health policy. JAMA 2003; 290:1624-1632.
299. Roland M, Torgerson DJ. What are pragmatic trials? BMJ 1998; 316:285.
300. Alexander GC, Stafford RS. Does comparative effectiveness have a comparative edge? JAMA 2009; 301:2488-2490