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Algrain H, Liu A, Singh S, Vu TN, Cohen SP. Cervical Epidural Depth: Correlation Between Cervical MRI Measurements of the Skin-to-Cervical Epidural Space and the Actual Needle Depth During Interlaminar Cervical Epidural Injections. PAIN MEDICINE 2019; 19:1015-1022. [PMID: 28482062 DOI: 10.1093/pm/pnx066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective The purpose of this study was to assess the correlation between skin-to-epidural space depth, as measured on cervical magnetic resonance imaging (MRI), and actual needle depth, as measured by Tuohy needle markings during cervical epidural steroid injections. Methods We conducted a retrospective review of cervical MRI images to determine estimated depth from skin to epidural space. Of the 121 reviewed patients who underwent cervical epidural steroid injections, 81 met inclusion criteria and were retained for data analysis. Results At the C6-C7 level, the estimated needle depth according to MRI images was 6.03 ± 1.15 cm (mean ± SD) and the actual needle depth was 5.62 ± 0.77 cm. At the C7-T1 level, the estimated needle depth based on MRI images was 5.90 ± 1.05 cm and the actual needle depth was 5.73 ± 0.98 cm. At both C6-C7 and C7-T1, MRI depth (P < 0.009, P < 0.001) and body mass index (P < 0.001, P < 0.002) were significantly associated with actual depth. Conclusions Estimates of needle depth made with MRI were consistently slightly deeper than the actual loss-of-resistance needle depth, indicating that the provider should employ caution when using MRI predictive depths. Information garnered from preprocedure MRIs can be used to improve the safety of cervical epidural steroid injection procedures.
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Affiliation(s)
- Haitham Algrain
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Wellspan Pain Management Clinic, York Hospital, York, Pennsylvania, USA
| | - Alison Liu
- Department of Cell and Systems Biology, University of Toronto, Toronto, Canada
| | - Sarabdeep Singh
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - To-Nhu Vu
- Wellspan Pain Management Clinic, York Hospital, York, Pennsylvania, USA
| | - Steven P Cohen
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Cervical Radicular Pain. Pain 2019. [DOI: 10.1007/978-3-319-99124-5_133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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3
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McCormick ZL, Mattie R, Ebrahimi A, Lee DT, Marcolina A, Press J, Kennedy DJ, Smuck M, Walega DR, Cushman D. Is There a Relationship Between Body Mass Index and Fluoroscopy Time During Cervical Interlaminar Epidural Steroid Injections? PAIN MEDICINE 2018; 18:1326-1333. [PMID: 28034968 DOI: 10.1093/pm/pnw264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background The challenge of obtaining medical imaging in individuals with higher body mass index (BMI) is described, but there is minimal data regarding the relationship between BMI and fluoroscopy time during cervical interlaminar epidural steroid injection (CIESI). Objective To determine the relationship between BMI and fluoroscopy time during CIESI. Methods Retrospective cohort study of patients who underwent fluoroscopically guided CIESI between January 2014 and February 2015 at an academic pain medicine center. Fluoroscopy time data were collected. Comparisons based on analysis of variance were made between patients with normal (<25.0 kg/m 2 ), overweight (25.0-29.9 kg/m 2 ), and obese (≥30.0 kg/m 2 ) BMI. Results Of 399 procedure encounters, 366 had documented BMI and fluoroscopy time data and were included for analysis. Mean age (± SD) in this cohort was 53 ± 13 years, including 189 females (52%) and 205 first-time injections. Mean fluoroscopy time for all injections was 18 ± 10 seconds. Separated by categorical BMI class, the mean fluoroscopy time was 18 ± 9 seconds for normal weight patients, 17 ± 10 seconds for overweight patients, and 20 ± 11 seconds for obese patients, respectively. Post hoc analysis showed that fluoroscopy time was significantly longer only in obese compared with overweight patients ( P = 0.02). Trainee involvement and first-time vs repeat injection did not significantly alter fluoroscopy time ( P = 0.17 and P = 0.12, respectively). Conclusions The findings of this study indicate that BMI does not appear to have a clinically significant impact on fluoroscopy time during cervical interlaminar epidural steroid injection procedures. Future study is needed to directly quantify radiation exposure in patients and practitioners, as well as the associated health risk.
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Affiliation(s)
- Zachary L McCormick
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
| | - Ryan Mattie
- Department of Orthopaedic Surgery, Stanford University, Palo Alto, California
| | - Ali Ebrahimi
- Department of Anesthesia, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - David T Lee
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Joel Press
- Department of Physical Medicine and Rehabilitation, the Rehabilitation Institute of Chicago, Chicago, Illinois
| | - D J Kennedy
- Department of Orthopaedic Surgery, Stanford University, Palo Alto, California
| | - Matthew Smuck
- Department of Orthopaedic Surgery, Stanford University, Palo Alto, California
| | - David R Walega
- Department of Anesthesia, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Daniel Cushman
- Department of Orthopaedic Surgery, Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA
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Ersen A, Sahin M. Polydimethylsiloxane-based optical waveguides for tetherless powering of floating microstimulators. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:55005. [PMID: 28500857 PMCID: PMC5997005 DOI: 10.1117/1.jbo.22.5.055005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 04/20/2017] [Indexed: 05/05/2023]
Abstract
Neural electrodes and associated electronics are powered either through percutaneous wires or transcutaneous powering schemes with energy harvesting devices implanted underneath the skin. For electrodes implanted in the spinal cord and the brain stem that experience large displacements, wireless powering may be an option to eliminate device failure by the breakage of wires and the tethering of forces on the electrodes. We tested the feasibility of using optically clear polydimethylsiloxane (PDMS) as a waveguide to collect the light in a subcutaneous location and deliver to deeper regions inside the body, thereby replacing brittle metal wires tethered to the electrodes with PDMS-based optical waveguides that can transmit energy without being attached to the targeted electrode. We determined the attenuation of light along the PDMS waveguides as 0.36 ± 0.03 ?? dB / cm and the transcutaneous light collection efficiency of cylindrical waveguides as 44 % ± 11 % by transmitting a laser beam through the thenar skin of human hands. We then implanted the waveguides in rats for a month to demonstrate the feasibility of optical transmission. The collection efficiency and longitudinal attenuation values reported here can help others design their own waveguides and make estimations of the waveguide cross-sectional area required to deliver sufficient power to a certain depth in tissue.
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Affiliation(s)
- Ali Ersen
- New Jersey Institute of Technology, Department of Biomedical Engineering, Newark, New Jersey, United States
| | - Mesut Sahin
- New Jersey Institute of Technology, Department of Biomedical Engineering, Newark, New Jersey, United States
- Address all correspondence to: Mesut Sahin, E-mail:
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Shanthanna H, Mendis N, Goel A. Cervical epidural analgesia in current anaesthesia practice: systematic review of its clinical utility and rationale, and technical considerations. Br J Anaesth 2016; 116:192-207. [PMID: 26787789 DOI: 10.1093/bja/aev453] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cervical epidural analgesia (CEA) is an analgesic technique, potentially useful for surgeries involving the upper body. Despite the inherent technical risks and systemic changes, it has been used for various surgeries. There have been no previously published systematic reviews aimed at assessing its clinical utility. This systematic review was performed to explore the perioperative benefits of CEA. The review was also aimed at identifying the rationale of its use, reported surgical indications and the method of use. We performed a literature search involving PubMed and Embase databases, to identify studies using CEA for surgical indications. Out of 467 potentially relevant articles, 73 articles were selected. Two independent investigators extracted data involving 5 randomized controlled trials, 17 observational comparative trials, and 51 case reports (series). The outcomes studied in most comparative studies were on effects of local anaesthetics and other agents, systemic effects, and feasibility of CEA. In one randomized controlled study, CEA was observed to decrease the resting pain scores after pharyngo-laryngeal surgeries. In a retrospective study, CEA was shown to decrease the cancer recurrence after pharyngeal-hypopharyngeal surgeries. The limited evidence, small studies, and the chosen outcomes do not allow for any specific recommendations based on the relative benefit or harm of CEA. Considering the potential for significant harm, in the face of better alternatives, its use must have a strong rationale mostly supported by unique patient and surgical demands. Future studies must aim to assess analgesic comparator effectiveness for clinically relevant outcomes.
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Affiliation(s)
- H Shanthanna
- Department of Anaesthesiology, St Joseph's Hospital, McMaster University, Hamilton, ON, Canada
| | - N Mendis
- Resident, Department of Anaesthesiology, University of Ottawa, Ottawa, ON, Canada
| | - A Goel
- Resident, Department of Anesthesiology, University of Toronto, Toronto, ON, Canada
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Ideal Cervical Epidural Injection Route: Interlaminar or Transforaminal. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2015. [DOI: 10.1007/s40141-015-0084-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cervical epidural steroid injections for the treatment of cervical spinal (neck) pain. Curr Pain Headache Rep 2013; 17:314. [PMID: 23315021 DOI: 10.1007/s11916-012-0314-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Cervical epidural steroid injections (CESI) are an accepted treatment for neck pain with a radicular component, and may be accomplished by using either transforaminal (CTFESI) or interlaminar (CILESI) approaches. CESIs are routinely performed using real-time fluoroscopic-guidance in conjunction with the injection of water soluble, iodine-based contrast media to enhance visualization of intravascular injections. Digital subtraction angiography (DSA) imaging is an adjuvant to fluoroscopic methods for visualizing blood vessels while performing spinal injections. However, as with any neuraxial procedure, various complications associated with CESIs have been reported. Complications are directly associated with the technical procedures of CESIs. Particulate steroids may have a prolonged duration of action but non-particulate steroids are safer for CESIs. Blunt-beveled needles are less likely than sharp-beveled needles to penetrate blood vessels to cause bleeding complications during CTFESI procedures. Small doses of local anesthetics appear to be safe and assist in identifying intravascular injections previously overlooked by conventional techniques.
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Park SY, Leem JG, Jung SH, Kim YK, Koh WU. An alternative approach to needle placement in cervicothoracic epidural injections. Korean J Pain 2012; 25:183-7. [PMID: 22787549 PMCID: PMC3389323 DOI: 10.3344/kjp.2012.25.3.183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 06/07/2012] [Accepted: 06/08/2012] [Indexed: 11/24/2022] Open
Abstract
The use of fluoroscopy guidance together with the loss of resistance technique during epidural injections has been advocated lately; moreover, epidural injections in the absence of fluoroscopic guidance have a high rate of inaccurate needle-tip placement during the injections. However, the approach to the lower cervical and upper thoracic epidural space may be challenging due to its obscure lateral fluoroscopic views from overlying normal tissue structures. In this case, we report an alternative oblique C-arm fluoroscopy guided view approach to supplement the standard anterior-posterior and lateral fluoroscopic views to facilitate successful needle placement and precise anatomical localization of the epidural space.
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Affiliation(s)
- Seung Yong Park
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Fujinaka MK, Lawson EF, Schulteis G, Wallace MS. Cervical epidural depth: correlation between needle angle, cervical anatomy, and body surface area. PAIN MEDICINE 2012; 13:665-9. [PMID: 22494564 DOI: 10.1111/j.1526-4637.2012.01361.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Prior to performing a cervical interlaminar epidural steroid injection (CIESI), knowledge of the depth from lamina to epidural space may assist in preventing cord injury. METHODS This is a prospective analysis of data including gender, age, weight, height, previous surgery, neck circumference, distances from tip of chin to sternal notch, occiput to C7 vertebral prominence, and ear lobe to tip of shoulder, pain score, angle from C7 vertebral prominence to the back, depth at which the Tuohy needle contacted T1 vertebral lamina and depth at which the epidural space was entered was conducted with 92 subjects, average age (± standard deviation [SD]) 41.3 ± 13.2 years underwent fluoroscopically guided C7-T1 intralaminar epidural steroid injections. RESULTS Depth to lamina was the best individual predictor with an r value of 0.86. Weight, neck circumference, and body mass index (BMI) positively correlated with depth to epidural space with r values of 0.66, 0.62, and 0.61, respectively. A linear regression model of depth to lamina for predicting depth to epidural space was accurate to within ± 0.5 cm of the actual depth in 69% of subjects. However, when comparing predicted with actual depth to epidural space for individual subjects, the prediction was inaccurate by as much as 1.6 cm deep or 1.7 cm shallow. CONCLUSIONS While statistically significant correlations do exist between both quantitative external body characteristics and depth to cervical epidural space and T1vertebral lamina to depth of cervical epidural space for fluoroscopically guided interlaminar epidural steroid injections at C7-T1, even the most optimal regression models do not permit clinical confidence in predicted depth to epidural space.
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Affiliation(s)
- Michael K Fujinaka
- University of California, San Diego, School of Medicine, La Jolla, California 92037-1300, USA
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Abbasi A, Malhotra G. The "swimmer's view" as alternative when lateral view is inadequate during interlaminar cervical epidural steroid injections. PAIN MEDICINE 2010; 11:709-12. [PMID: 20353409 DOI: 10.1111/j.1526-4637.2010.00829.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To present a technique that better visualizes the needle during interlaminar cervical epidural steroid injection (ICESI) in patients where the lateral view is inadequate. DESIGN Case report. SETTING Private group practice. SUBJECT A 57-year-old morbidly obese male presenting for ICESI for left neck and upper limb pain after a motor vehicle accident. Magnetic resonance imaging revealed left C6-7 herniated nucleus pulposis and C4-5 osteophytic disc-ridge complex. Electrodiagnostic evaluation revealed activity consistent with a left C7 radiculopathy. INTERVENTION Left C7-T1 ICESI. Needle was obscured in the lateral view by the patient's shoulders. Needle was made visible by positioning the patient for Swimmer's view. RESULTS Full resolution of symptoms without associated complications. CONCLUSIONS Grave complications have been associated with ICESI necessitating impeccable and systematic technique with substantial knowledge of anatomy. Although injection at lower levels is advocated for safety concerns, the needle during lateral view may be obscured by the shoulders in some patients. The "Swimmer's View" position may be attempted when lateral view is insufficient to visualize needle during ICESI.
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Affiliation(s)
- Arjang Abbasi
- Interventional Pain Management and Spine Rehabilitation, Long Island Spine Specialists, New York, NY 11725, USA.
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Ryoo SH, Kim TJ, Ok SY, Kim SH, Park W, Song D, Moon C. Cervical Epidural Anesthesia for Arteriovenous Bridge Graft at Upper Arm in Chronic Renal Failure Patients. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2010. [DOI: 10.4174/jkss.2010.79.6.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Seung Hwa Ryoo
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Tae Joon Kim
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Si Young Ok
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Sang Ho Kim
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Wook Park
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Dan Song
- Department of General Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Chul Moon
- Department of General Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
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Brummett CM, Williams BS, Hurley RW, Erdek MA. A prospective, observational study of the relationship between body mass index and depth of the epidural space during lumbar transforaminal epidural steroid injection. Reg Anesth Pain Med 2009; 34:100-5. [PMID: 19282707 PMCID: PMC2715548 DOI: 10.1097/aap.0b013e31819a12ba] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Previous studies have concluded that transforaminal epidural steroid injections (ESIs) are more effective than interlaminar injections in the treatment of radiculopathies due to lumbar intervertebral disk herniation. There are no published studies examining the depth of epidural space using a transforaminal approach. We investigated the relationship between body mass index (BMI) and the depth of the epidural space during lumbar transforaminal ESIs. METHODS Eighty-six consecutive patients undergoing lumbar transforaminal ESI at the L3-L4, L4-L5, and L5-S1 levels were studied. Using standard protocol, the foraminal epidural space was attained using fluoroscopic guidance. The measured distance from needle tip to skin was recorded (depth to foraminal epidural space). The differences in the needle depth and BMI were analyzed using regression analysis. RESULTS Needle depth was positively associated with BMI (regression coefficient [RC], 1.13; P < 0.001). The median depths (in centimeters) to the epidural space were 6.3, 7.5, 8.4, 10.0, 10.4, and 12.2 for underweight, normal, preobese, obese I, obese II, and obese III classifications, respectively. Sex (RC, 1.3; P = 0.02) and race (RC, 0.8; P = 0.04) were also significantly associated with needle depth; however, neither factor remained significant when BMI was accounted as a covariate in the regression model. Age, intervertebral level treated, and oblique angle had no predictive value on foraminal depth (P > 0.2). CONCLUSION There is a positive association between BMI and transforaminal epidural depth, but not with age, sex, race, oblique angle, or intervertebral level.
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Affiliation(s)
- Chad M Brummett
- Division of Pain Medicine, Department of Anesthesiology, University of Michigan, Ann Arbor, MI 48109, USA
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Han MA. Low Extremity Weakness after Cervical Epidural Steroid Injection in Previous Spinal Surgery Patient - A case report -. Korean J Anesthesiol 2008. [DOI: 10.4097/kjae.2008.54.5.593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Mi-Ae Han
- Department of Anesthesiology and Pain Medicine, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea
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Abbasi A, Malhotra G, Malanga G, Elovic EP, Kahn S. Complications of interlaminar cervical epidural steroid injections: a review of the literature. Spine (Phila Pa 1976) 2007; 32:2144-51. [PMID: 17762818 DOI: 10.1097/brs.0b013e318145a360] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
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 procedure, a number of minor and major complications have been reported across the literature. Thus far, reports of complications are limited to retrospective studies, case reports, and data extrapolated from lumbar and thoracic procedures. As a result, the past literature has been of limited value with regard to facilitating both clinical care and future research efforts. METHODS Medical databases were searched for studies of ICESI. The bibliographies of these papers were then searched as well. Papers focusing on cervical techniques that did not involve injection into the epidural space were discarded, as were studies of thoracic and lumbar spine injections. Reports of complications associated with ICESI were further subdivided into major and minor categories. RESULTS The reported rate of complications associated with ICESI varied between 0 and 16.8%. CONCLUSION There are significant limitations in the available literature discussing the complications associated with ICESI, but they strongly suggest that ICESI is a relatively safe procedure. Numerous potential adverse reactions have been associated with ICESI, with the vast majority being minor and transient in nature. However, serious complications may also result and may be technique related. Injectionists should be aware of the clinical presentations, rates, potential consequences, and appropriate techniques to avoid these complications. More studies are needed with specific focus on cervical complication rates, standardization of injection techniques, and differentiation between complications and poor efficacy. In addition, the use of a prospective randomized blinded controlled design would be beneficial.
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Affiliation(s)
- Arjang Abbasi
- Long Island Spine Specialists, Commack, NY 11725, USA.
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Kang SS, Choi ES, Park JH, Hong SJ, Kim IS, Yun YJ, Shin KM. Cervical Transforaminal Axis Measured by MRI and Its Relation to the Internal Jugular Vein, Internal Carotid Artery and Vertebral Artery. Korean J Pain 2007. [DOI: 10.3344/kjp.2007.20.2.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sang Soo Kang
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Seoul, Korea
| | - Eun Seon Choi
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Seoul, Korea
| | - Jun Hee Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Seoul, Korea
| | - Seong Jun Hong
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Seoul, Korea
| | - Il Seok Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Seoul, Korea
| | - Yeong Jun Yun
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Seoul, Korea
| | - Keun Man Shin
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Seoul, Korea
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Jo DH, Kim MH, Ahn SY, Park SH, Lee KC. A Comparison of the Spread Level of the Cervical Epidural Block in Terms of Volume. Korean J Pain 2007. [DOI: 10.3344/kjp.2007.20.1.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Dae Hyun Jo
- Pain Clinic, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Myoung Hee Kim
- Department of Anesthesiology and Pain Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Sun Yeon Ahn
- Pain Clinic, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Sa Hyun Park
- Pain Clinic, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea
| | - Kang Chang Lee
- Department of Anesthesiology and Pain Medicine, Wonkwang University Sanbon Medical Center, School of Medicine, Wonkwang University, Gunpo, Korea
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