Complications of Interlaminar Cervical Epidural Steroid Injections: A Review of the Literature

  title={Complications of Interlaminar Cervical Epidural Steroid Injections: A Review of the Literature},
  author={Arjang Abbasi and Gautam K. Malhotra and Gerard A. Malanga and Elie P. Elovic and Stuart B. Kahn},
Study Design. A comprehensive literature review. Objectives. To review and critically evaluate the past literature focusing on incidence and clinical presentation of complications associated with interlaminar cervical epidural steroid injection (ICESI). The overall goal is to guide the direction of future research and improve clinical care by increasing awareness of complications, their presentations, and management. Summary of Background Data. Although ICESI is considered a relatively safe… 

Complications of Transforaminal Cervical Epidural Steroid Injections

It is imperative for injectionists to standardize techniques to minimize complications, especially by using a test dose of local anesthetic before injection of preferably nonparticulate corticosteroid, as mentioned in the literature.

Complications of Cervical Transforaminal Epidural Steroid Injections

This review aims to review and critically evaluate literature focusing on the incidence and clinical presentations of major complications associated with cervical transforaminal steroid injections to identify pertinent journal information that aids in the improvement in clinical care and guides future research.

Cervical Epidural Injection Complicated By Syrinx Formation: A Case Report

A rare complication of syrinx formation resulting from a CEI is reported in this case report, which is thought to be a relatively safe procedure.

Cervical Interlaminar Epidural Steroid Injection for Unilateral Cervical Radiculopathy: Comparison of Midline and Paramedian Approaches for Efficacy

There is no significant difference in treatment efficacy between the midline and paramedian approaches in CIESI, for unilateral radiculopathy; patients with disc herniation experience better pain relief than those with neural foraminal stenosis.

Spinal Cord Injury During Attempted Cervical Interlaminar Epidural Injection of Steroids

This work describes and analyzes a case where an inadvertent injection of contrast medium into the cervical spinal cord occurred and presents the first published oblique fluoroscopic image of an intramedullary injection.

Safety of epidural steroid injections

The risks of ESIs are outlined and in doing so help shed light on the procedural risks versus the risks of the medication, which will help differentiate minor adverse events from significant permanent complications.

Major risks and complications of cervical epidural steroid injections: An updated review

  • N. Epstein
  • Medicine
    Surgical neurology international
  • 2018
Complications of cervical CESI/TF-CESI injections producing epidural hematoma, new neurological deficits (intramedullary injections), or intravascular injections resulting in strokes to the cord, brain stem, and cerebellum are often underreported.

Clinical Outcomes of Cervical Radiculopathy Following Epidural Steroid Injection: A Prospective Study With Follow-up for More Than 2 Years

In more than 80% of patients with CR who were surgical candidates, surgery was avoided using ESI, and ESI is considered a safe and effective treatment to choose before undergoing surgery.

[Cervical epidural steroid injections for symptomatic disc herniations].

The CESI application is an effective method in the treatment of cervical radiculopathy and reduces the rate of patients needing surgery.

Is Cervical Epidural Steroid Injection Safe and Efficacious for the Treatment of Cervical Radiculopathy?

It is suggested that CESI should have a role in the treatment algorithm of cervical radiculopathy, and several other publications have supported the safety and efficacy of CESI in patients with cervical radiulopathy who did not meet surgical indications.



The technical aspects of epidural steroid injections: a national survey.

There is no clear-cut consensus as to the ideal method to perform epidural steroid injections, and there is a wide variation among individual practices in almost every technical aspect of ESI.

Therapeutic spinal corticosteroid injections for the management of radiculopathies.

  • C. SlipmanD. Chow
  • Medicine
    Physical medicine and rehabilitation clinics of North America
  • 2002

Complications of fluoroscopically guided interlaminar cervical epidural injections.

Cervical Epidural Abscess After Epidural Steroid Injection

The patient had partial recovery of neurologic function within the first 24 hours after decompressive laminectomy, irrigation, and debridement and there was no perioperative complications at 7-month follow-up.

Complications Associated With Epidural Steroid Injections

There are few published reports of serious complications following epidural steroid injections, most of which were associated with multiple injections over a prolonged time period.

Contrast Flow Characteristics in the Cervical Epidural Space: An Analysis of Cervical Epidurograms

In cervical epidural steroid injections performed in the midline at C6–C7 and C7–T1, the contrast consistently covers the dorsal cervical epiduran space bilaterally, irrespective of the volume used or neck flexion angle used, which suggests that solutions introduced here would cover the dorsal spinal epidural space.

Nonoperative Management of Herniated Cervical Intervertebral Disc With Radiculopathy

Many cervical disc herniations can be successfully managed with aggressive nonsurgical treatment (24 of 26 in the present study), and high patient satisfaction with nonoperative care was achieved on outcome analysis.

Outcome in patients with cervical radiculopathy. Prospective, multicenter study with independent clinical review.

This study represents the first in-depth, prospective outcome analysis of patients with cervical spondylotic and discogenic radiculopathy and shows thaturgically treated patients had a significant improvement in pain, neurologic symptoms, functional status, and ability to perform activities of daily living.

The Role of Fluoroscopy in Cervical Epidural Steroid Injections: An Analysis of Contrast Dispersal Patterns

The loss of resistance technique may not be an adequate method for ensuring accurate needle placement in blindly performed cervical epidural injections, but the use of epidurography can improve the accuracy of needle placement and medication delivery to targeted areas of pathology.

Epidural Analgesic Techniques in the Management of Cervical Pain

Anesthesiologists should add to their armamentarium the use of such techniques in the management of patients with acute and chronic cervical radiculopathy.