Digital subtraction angiography does not reliably prevent paraplegia associated with lumbar transforaminal epidural steroid injection

Pain Physician

Volumn 15, Issue 6, 2012, Pages 515-523

  Chang Chien, George C ^a   Candido, Kenneth D ^b,c   Knezevic, Nebojsa Nick ^b,c  

^a NORTHWESTERN UNIVERSITY   (United States)

^b ADVOCATE ILLINOIS MASONIC MEDICAL CENTER   (United States)

^c UNIVERSITY OF ILLINOIS   (United States)

Author keywords

Chronic low back pain; Digital subtraction angiography; Paraplegia; Transforaminal epidural steroid injections

Indexed keywords

CONTRAST MEDIUM; DEXAMETHASONE; LIDOCAINE; METHYLPREDNISOLONE; TRIAMCINOLONE ACETONIDE;

AGED; ARTICLE; ASPIRATION; CASE REPORT; CONTRAST ENHANCEMENT; DIAPHORESIS; DIGITAL SUBTRACTION ANGIOGRAPHY; DISEASE SEVERITY; EMERGENCY WARD; FECES INCONTINENCE; FLUOROSCOPY; FOLLOW UP; HUMAN; IMAGE ANALYSIS; INTENSIVE CARE UNIT; KINESIOTHERAPY; LEG PAIN; LIMB WEAKNESS; LOCAL ANESTHESIA; MALE; NEURALGIA; NEUROLOGIC EXAMINATION; NUCLEAR MAGNETIC RESONANCE IMAGING; PAIN ASSESSMENT; PAIN CLINIC; PARAPLEGIA; PARESTHESIA; RADICULOPATHIC PAIN; REHABILITATION CARE; RELIABILITY; SPINAL CORD DISEASE; SPINAL CORD INFARCTION; SPINAL NEEDLE; SPINE RADIOGRAPHY; STEROID THERAPY; TRANSFORAMINAL EPIDURAL STEROID INJECTION; VERTEBRAL CANAL STENOSIS;

AGED, 80 AND OVER; ANESTHETICS, LOCAL; ANGIOGRAPHY, DIGITAL SUBTRACTION; HUMANS; INJECTIONS, EPIDURAL; LIDOCAINE; LUMBOSACRAL REGION; MALE; PARAPLEGIA; RADIOGRAPHY, INTERVENTIONAL; SPINAL CORD ISCHEMIA; SPINAL STENOSIS;

EID: 84869807772     PISSN: 15333159     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (59)

1. Baker R, Dreyfuss P, Mercer S, Bogduk N. Cervical transforaminal injection of corticosteroids into a radicular artery: A possible mechanism for spinal cord injury. Pain 2003; 103:211-215.
2. Jasper JF. Role of digital subtraction fluoroscopic imaging in detecting intravascular injections. Pain Physician 2003; 6:369-372.
3. Kim do W, Han KR, Kim C, Chae YJ. Intravascular flow patterns in transforaminal epidural injections: A comparative study of the cervical and lumbar vertebral segments. Anesth Analg 2009; 109:233-239.
4. Lutz GE, Vad VB, Wisneski RJ. Fluoroscopic transforaminal lumbar epidural steroids: An outcome study. Arch Phys Med Rehabil 1998; 79:1362-1366.
5. Vad VB, Bhat AL, Lutz GE, Cammisa F. Transforaminal epidural steroid injections in lumbosacral radiculopathy: A prospective randomized study. Spine (Phila Pa 1976) 2002; 27:11-16.
6. Rosenberg SK, Grabinsky A, Kooser C, Boswell MV. Effectiveness of transforaminal epidural steroid injections in low back pain: A one year experience. Pain Physician 2002; 5:266-270.
7. Yang SC, Fu TS, Lai PL, Niu CC, Chen LH, Chen WJ. Transforaminal epidural steroid injection for discectomy candidates: An outcome study with a minimum of two-year follow-up. Chang Gung Med J 2006; 29:93-99.
8. Lee JW, Kim SH, Lee IS, Choi JA, Choi JY, Hong SH, Kang HS. Therapeutic effect and outcome predictors of sciatica treated using transforaminal epidural steroid injection. AJR Am J Roentgenol 2006; 187:1427-1431.
9. 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; 81:1045-1050.
10. Huston CW, Slipman CW, Garvin C. Complications and side effects of cervical and lumbosacral selective nerve root injections. Arch Phys Med Rehabil 2005; 86:277-283.
11. 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.
12. Smuck MW, Levin JH, 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. Spine (Phila Pa 1976) 2007; 32:2638.
13. Karasek M, Bogduk N. Temporary neurologic deficit after cervical transforaminal injection of local anesthetic. Pain Med 2004; 5:202-205.
14. Beckman WA, Mendez RJ, Paine GF, Mazzilli MA. Cerebellar herniation after cervical transforaminal epidural injection. Reg Anesth Pain Med 2006; 31:282-285.
15. Muro K, O'Shaughnessy B, Ganju A. Infarction of the cervical spinal cord following multilevel transforaminal epidural steroid injection: Case report and review of the literature. J Spinal Cord Med 2007; 30:385-388.
16. Lee JH, Lee JK, Seo BR, Moon SJ, Kim JH, Kim SH. Spinal cord injury produced by direct damage during cervical transforaminal epidural injection. Reg Anesth Pain Med 2008; 33:377-379.
17. Tiso RL, Cutler T, Catania JA, Whalen K. Adverse central nervous system sequelae after selective transforaminal block: The role of corticosteroids. Spine J 2004; 4:468-474.
18. Rozin L, Rozin R, Koehler SA, Shakir A, Ladham S, Barmada M, Dominick J, Wecht CH. Death during transforaminal epidural steroid nerve root block (C7) due to perforation of the left vertebral artery. Am J Forensic Med Pathol 2003; 24:351-355.
19. Fitzgibbon DR, Posner KL, Domino KB, Caplan RA, Lee LA, Cheney FW. Chronic pain management: American Society of Anesthesiologists Closed Claims Project. Anesthesiology 2004; 100:98-105.
20. 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.
21. Knight JW, Cordingley JJ, Palazzo MG. Epidural abscess following epidural steroid and local anaesthetic injection. Anaesthesia 1997; 52:576-578.
22. Dougherty JH, Jr., Fraser RA. Complications following intraspinal injections of steroids. Report of two cases. J Neurosurg 1978; 48:1023-1025.
23. McMillan MR, Crumpton C. Cortical blindness and neurologic injury complicating cervical transforaminal injection for cervical radiculopathy. Anesthesiology 2003; 99:509-511.
24. Reitman CA, Watters W, 3rd. Subdural hematoma after cervical epidural steroid injection. Spine (Phila Pa 1976) 2002; 27:E174-176.
25. Derby R, Bogduk N, Kine G. Precision percutaneous blocking procedures for localizing spinal pain. Part 2. Pain Digest 1993; 3:175-188.
26. Brouwers PJ, Kottink EJ, Simon MA, Prevo RL. A cervical anterior spinal artery syndrome after diagnostic blockade of the right C6-nerve root. Pain 2001; 91:397-399.
27. Nahm FS, Lee CJ, Lee SH, Kim TH, Sim WS, Cho HS, Park SY, Kim YC, Lee SC. Risk of intravascular injection in transforaminal epidural injections. Anaesthesia 2010; 65:917-921.
28. Quintero N, Laffont I, Bouhmidi L, Rech C, Schneider AE, Gavardin T, Dizien O. Transforaminal epidural steroid injection and paraplegia: Case report and bibliographic review [in French]. Ann Readapt Med Phys 2006; 49:242-247.
29. Candido KD, Ghaly RF, Mackerley S, Knezevic NN. A Whitacre-type spinal needle does not prevent intravascular injection during cervical nerve root injections. South Med J 2010; 103:679-682.
30. Smuck M, Yu AJ, Tang CT, Zemper E. Influence of needle type on the incidence of intravascular injection during transforaminal epidural injections: A comparison of short-bevel and long-bevel needles. Spine J 2010; 10:367-371.
31. Dreyfuss P, Baker R, Bogduk N. Comparative effectiveness of cervical transforaminal injections with particulate and nonparticulate corticosteroid preparations for cervical radicular pain. Pain Med 2006; 7:237-242.
32. Smuck M, Maxwell MD, Kennedy D, Rittenberg JD, Lansberg MG, Plastaras CT. Utility of the anesthetic test dose to avoid catastrophic injury during cervical transforaminal epidural injections. Spine J 2010; 10:857-864.
33. Derby R, Lee SH, Date ES, Lee JH, Lee CH. Size and aggregation of corticosteroids used for epidural injections. Pain Med 2008; 9:227-234.
34. Benzon HT, Chew TL, McCarthy RJ, Benzon HA, Walega DR. Comparison of the particle sizes of different steroids and the effect of dilution: A review of the relative neurotoxicities of the steroids. Anesthesiology 2007; 106:331-338.
35. MacMahon PJ, Shelly MJ, Scholz D, Eustace SJ, Kavanagh EC. Injectable corticosteroid preparations: An embolic risk assessment by static and dynamic microscopic analysis. AJNR Am J Neuroradiol 2011; 32:1830-1835.
36. 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.
37. Lee JW, Park KW, Chung SK, Yeom JS, Kim KJ, Kim HJ, Kang HS. Cervical transforaminal epidural steroid injection for the management of cervical radiculopathy: A comparative study of particulate versus non-particulate steroids. Skeletal Radiol 2009; 38:1077-1082.
38. Okubadejo GO, Talcott MR, Schmidt RE, Sharma A, Patel AA, Mackey RB, Guarino AH, Moran CJ, Riew KD. Perils of intravascular methylprednisolone injection into the vertebral artery. An animal study. J Bone Joint Surg Am 2008; 90:1932-1938.
39. Furman MB, Giovanniello MT, O'Brien EM. Incidence of intravascular penetration in transforaminal cervical epidural steroid injections. Spine (Phila Pa 1976) 2003; 28:21-25.
40. Houten JK, Errico TJ. Paraplegia after lumbosacral nerve root block: Report of three cases. Spine J 2002; 2:70-75.
41. Manchikanti L, Bakhit CE, Pakanati RR, Fellows B. Fluoroscopy is medically necessary for the performance of epidural steroids. Anesth Analg 1999; 89:1330-1331.
42. 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.
43. Renfrew DL, Moore TE, Kathol MH, el-Khoury GY, Lemke JH, Walker CW. Correct placement of epidural steroid injections: Fluoroscopic guidance and con trast administration. AJNR Am J Neuroradiol 1991; 12:1003-1007.
44. Mehta M, Salmon N. Extradural block. Confirmation of the injection site by X-ray monitoring. Anaesthesia 1985; 40:1009-1012.
45. 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.
46. Smuck M, Fuller BJ, Chiodo A, Benny B, Singaracharlu B, Tong H, Ho S. Accuracy of intermittent fluoroscopy to detect intravascular injection during transforaminal epidural injections. Spine (Phila Pa 1976) 2008; 33:E205-210.
47. Smuck M, Fuller BJ, Yoder B, Huerta J. Incidence of simultaneous epidural and vascular injection during lumbosacral transforaminal epidural injections. Spine J 2007; 7:79-82.
48. Rathmell JP, Aprill C, Bogduk N. Cervical transforaminal injection of steroids. Anesthesiology 2004; 100:1595-1600.
49. Lee MH, Yang KS, Kim YH, Jung HD, Lim SJ, Moon DE. Accuracy of live fluoroscopy to detect intravascular injection during lumbar transforaminal epidural injections. Korean J Pain 2010; 23:18-23.
50. McLean JP, Sigler JD, Plastaras CT, Garvan CW, Rittenberg JD. The rate of detection of intravascular injection in cervical transforaminal epidural steroid injections with and without digital subtraction angiography. PM R 2009; 1:636-642.
51. Koshino T, Murakami G, Morishita K, Mawatari T, Abe T. Does the Adamkiewicz artery originate from the larger segmental arteries? J Thorac Cardiovasc Surg 1999; 117:898-905.
52. Takase K, Sawamura Y, Igarashi K, Chiba Y, Haga K, Saito H, Takahashi S. Demonstration of the artery of Adamkiewicz at multi-detector row helical CT. Radiology 2002; 223:39-45.
53. Biglioli P, Spirito R, Roberto M, Grillo F, Cannata A, Parolari A, Maggioni M, Coggi G. The anterior spinal artery: The main arterial supply of the human spinal cord--a preliminary anatomic study. J Thorac Cardiovasc Surg 2000; 119:376-379.
54. Novy J, Carruzzo A, Maeder P, Bogousslavsky J. Spinal cord ischemia: Clinical and imaging patterns, pathogenesis, and outcomes in 27 patients. Arch Neurol 2006; 63:1113-1120.
55. Hong MK, Hong MK, Pan WR, Wallace D, Ashton MW, Taylor GI. The angiosome territories of the spinal cord: Exploring the issue of preoperative spinal angiography. Laboratory investigation. J Neurosurg Spine 2008; 8:352-364.
56. Ziai WC, Ardelt AA, Llinas RH. Brainstem stroke following uncomplicated cervical epidural steroid injection. Arch Neurol 2006; 63:1643-1646.
57. Suresh S, Berman J, Connell DA. Cerebellar and brainstem infarction as a complication of CT-guided transforaminal cervical nerve root block. Skeletal Radiol 2007; 36:449-452.
58. Wallace MA, Fukui MB, Williams RL, Ku A, Baghai P. Complications of cervical selective nerve root blocks performed with fluoroscopic guidance. AJR Am J Roentgenol 2007; 188:1218-1221.
59. Choi YK, Barbella JD. Evaluation of epidurographic contrast patterns with fluoroscopic-guided lumbar interlaminar ventral epidural injection. Pain Pract 2009; 9:275-281.