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BACKGROUND Epidural glucocorticoid injections are widely used to treat symptoms of lumbar spinal stenosis, a common cause of pain and disability in older adults. However, rigorous data are lacking regarding the effectiveness and safety of these injections. METHODS In a double-blind, multisite trial, we randomly assigned 400 patients who had lumbar central(More)
SETTING Interventional procedures directed toward sources of pain in the axial and appendicular musculoskeletal system are performed with increasing frequency. Despite the presence of evidence-based guidelines for such procedures, there are wide variations in practice. Case reports of serious complications such as spinal cord infarction or infection from(More)
OBJECT Patients with radiculopathy, with or without back pain, often do not respond to conservative care and may be considered for epidural steroid injection therapy or a disc decompression procedure. Plasma disc decompression (PDD) using the Coblation SpineWand device is a percutaneous, minimally invasive interventional procedure. The purpose of this study(More)
BACKGROUND CONTEXT Vascular etiologies are a significant source of radiculopathy. The entities that are reviewed here include epidural spinal hematoma, subdural spinal hematoma, spinal arteriovenous malformation, vertebral hemangioma, spinal epidural cavernous hemangioma, vertebral artery anomalies (both tortuosity and dissection), aortic aneurysm,(More)
BACKGROUND CONTEXT The incidence of vascular penetration during contrast confirmed fluoroscopically guided transforaminal lumbosacral epidural injections has been reported as 8.9% to 21.3% depending on the level of injection. Recently, intermittent fluoroscopy was shown to miss more than half of the vascular injections observed under live fluoroscopy. The(More)
OBJECTIVES To develop and implement methodologies for characterizing accelerometry-derived patterns of physical activity (PA) in the United States in relation to demographics, anthropometrics, behaviors, and comorbidities using the National Health and Nutrition Examination Survey (NHANES) dataset. DESIGN Retrospective analysis of nationally representative(More)
BACKGROUND CONTEXT Reports of serious complications from cervical transforaminal epidural corticosteroid injections often consider accidental intra-arterial injection the most likely mechanism of injury. As a result, many physicians have instituted methods to prevent intravascular injections. Routine use of the anesthetic test dose is one such method. The(More)
BACKGROUND AND PURPOSE Outcome measurement has been shown to improve performance in several fields of healthcare. This understanding has driven a growing interest in value-based healthcare, where value is defined as outcomes achieved per money spent. While low back pain (LBP) constitutes an enormous burden of disease, no universal set of metrics has yet(More)
STUDY DESIGN Case report and review of the literature. OBJECTIVE To report the first case of inadvertent injection of a cervical radicular artery using an atraumatic pencil-point needle. SUMMARY OF BACKGROUND DATA Rare complications from cervical transforaminal epidural corticosteroid injection have resulted in infarction of the spinal cord and brain.(More)
STUDY DESIGN Prospective validity study. OBJECTIVE To determine how accurately intermittent fluoroscopy detects inadvertent intravascular injection during transforaminal epidurals. SUMMARY OF BACKGROUND DATA Serious morbidity caused by transforaminal epidural injections is frequently related to inadvertent vascular injection of corticosteroids. Several(More)