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Results for “Injections, Spinal”

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At least 19 recordsLinked to original sources
PubMed2003

Prevention and management of complications resulting from common spinal injections.

When spinal injections are performed, a needle is placed in or around the spine making the risk of complications unavoidable. Spinal structures or adjacent organs are at risk for direct needle trauma, infection, hematoma, hemorrhage, nerve damage, stroke, allergic reaction, or spinal anesthesia with cardiorespiratory arrest. As a result, physician knowledge and patient preparation and monitoring are critical in maximizing patient safety during the procedure being performed. This review describes complications that may result from commonly performed spinal injections and their treatment.

Journal Article↗
PubMed2005

Unintentional vascular uptake in fluoroscopically guided, contrast-confirmed spinal injections: a 1-yr clinical experience and discussion of findings.

OBJECTIVE: Documentation of vascular uptake on spinal injection in the context of negative aspiration and negative passive filling of blood into the hub of the needle. DESIGN: A total of 1,295 consecutive outpatients receiving fluoroscopically guided, contrast-confirmed injection in a multispecialty practice over a 1-yr time frame were retrospectively reviewed with passive observation for inadvertent vascular uptake, passive filling, and required repositioning. RESULTS: Positive vascular uptake was seen in 2-13% of cases with variable degrees of aspiration, passive filling, and required needle repositionings to avoid vascular uptake. CONCLUSION: Negative aspiration and allotment for passive filling is inadequate to confirm the absence of vascular injection. Spinal injection will never be risk free. The safest method is fluoroscopically guided, contrast-confirmed injection, which should be considered the current standard of care.

Adult↗
PubMed2000

Complications of common selective spinal injections: prevention and management.

Selective spinal injections are being performed with increasing frequency in the management of acute and chronic pain syndromes. Because these procedures require a needle to be placed in or around the spine, there is always a risk of complications. For this reason, prevention, early recognition, and management of complications are paramount to patient care. Physician training and patient preparation and monitoring are required to maximize the safety and efficacy of the specific spinal procedures. This focused review article discusses the primary general and specific complications of spinal injection procedures as well as treatments.

Analgesics↗
PubMed1985

Treatment of backache with spinal injections of local anesthetics, spinal and systemic steroids. A review.

Low back pain and sciatica have been treated with peridural local anesthetics for over 80 years and with epidural and subarachnoid steroid injections for a quarter of a century. This review surveyed the literature concerning the evolution, pathophysiology, complications and results of this type of therapy. The volume injected and the method used vary with different physicians and no standard has been established. Good results from this treatment which vary from 20 to 95% decrease on long-term follow up. Statistical significance is absent if compared with other forms of therapy. It is the authors' opinion that the rationale for the use of spinal local analgesics or steroids or intramuscular steroids has not been scientifically proven. Complications with the use of subarachnoid steroids are sufficiently serious that this form of therapy should be condemned. In this age of accountability it is imperative that therapies with questionable benefits should be critically evaluated.

Adrenal Cortex Hormones↗
PubMed2000

Incidence of intravascular uptake in lumbar spinal injection procedures.

STUDY DESIGN: Multicenter, prospective, observational study. OBJECTIVES: To document the incidence of and factors associated with intravascular uptake during lumbar spinal injection procedures. SUMMARY OF BACKGROUND DATA: In prior reports, the incidence of inadvertent intravascular needle placement during contrast-enhanced, fluoroscopically guided lumbar spinal injection procedures has been incidentally noted to range from 6.4% to 9.2%. We present the first systematic prospective documentation of intravascular uptake of contrast dye during different types of lumbar injection procedures. METHODS: Fifteen interventional spine physicians in seven centers recorded data regarding intravascular uptake during 1219 contrast-enhanced, fluoroscopically guided lumbar spinal injection procedures. RESULTS: The overall incidence of intravascular uptake during lumbar spinal injection procedures as determined by contrast enhanced fluoroscopic observation is 8.5%. Caudal and transforaminal routes have the highest rates at 10.9% and 10.8%, respectively, followed by zygapophyseal joint (6.1%), sacroiliac joint (5.3%), and translaminar (1.9%) injections. Intravascular uptake is twice as likely to occur in those patients over rather than under 50 years of age. Preinjection aspiration failed to produce a flashback of blood in 74% of cases that proved to be intravascular upon injection of contrast dye. CONCLUSION: The incidence of intravascular uptake during lumbar spinal injection procedures is approximately 8.5%. The route of injection and the age of the patient greatly affect this rate. Absence of flashback of blood upon preinjection aspiration does not predict extravascular needle placement. Contrast-enhanced, fluoroscopic guidance is recommended when doing lumbar spinal injection procedures to prevent inadvertent intravascular uptake of injectate.

Adolescent↗
PubMed2003

Visualization of spinal injection procedures using gadolinium contrast.

STUDY DESIGN: A series of six case reports. OBJECTIVE: The case reports demonstrate successful use of gadolinium contrast for visualization of spinal injection procedures. SUMMARY OF BACKGROUND DATA: A variety of spinal injection procedures were performed with gadolinium contrast. Adequate visualization was accomplished with gadolinium in performing these injections and demonstrated that it is a viable alternative to nonionic iodinated contrast materials. MATERIALS AND METHODS: The case reports included a chart review, performance of spinal injections with gadolinium under fluoroscopic guidance, and postprocedure follow-up at 2 and 12 weeks. RESULTS: Gadolinium was visible under fluoroscopy in all six cases, demonstrating its value in performing spinal injection procedures as an alternative to nonionic iodinated contrast materials. CONCLUSION: Gadolinium is a viable alternative to nonionic iodinated contrast materials for visualization of spinal injection procedures.

Contrast Media↗
PubMed2002

Spinal injection procedures: volume, provider distribution, and reimbursement in the U.S. medicare population from 1993 to 1999.

PURPOSE: To evaluate spinal injection procedures for trends in volume, reimbursement, and physician specialty participation. MATERIALS AND METHODS: By using the 1993, 1996, 1998, and 1999 Medicare Part B claims database, we studied Current Procedural Terminology revision 4 codes used for percutaneous spinal injection procedures, including cervical and lumbar discography, disk aspiration and/or injection, facet and/or perifacet joint injection, and epidural steroid injection. For each of these procedures, volume, reimbursement, and physician specialty participation (categorized as radiology, anesthesiology, surgery, physiatry, and other specialties) for each year were recorded. RESULTS: Despite an overall increase in spinal injection procedure volume and reimbursement from 1993 to 1999, nonradiologists performed most of these procedures. Epidural steroid and facet joint injections had the highest volume and reimbursement during this time period and were performed almost exclusively by nonradiologists (predominantly anesthesiologists). Radiologists performed more discography procedures than did other specialists in 1993, but participation decreased each year, while anesthesiologist participation increased; as of 1999, anesthesiologists performed more discography procedures than did radiologists. Although radiologists performed more disk aspiration procedures than did other specialists, procedure volume remained low during the period studied. CONCLUSION: Spinal injection volume and reimbursement have increased substantially in the Medicare population from 1993 to 1999. During this interval, radiologist participation has decreased. Nonradiologists perform most spinal injection procedures.

Humans↗