| アブストラクト | PURPOSE: Cervical transforaminal epidural steroid injections (CTFESIs) have become an increasingly utilised means of treating radicular pain over recent decades, although a number of reports have brought their safety into question. Much of this has been attributed to the use of particulate steroids and the theoretical risk of embolic complications with inadvertent intra-arterial injection. This study documents the complications encountered at our centre when performing CTFESI over a more than 10-year study period with predominant use of particulate steroid. Our procedural technique is also described. This study aims to highlight the importance of operator technique first and foremost and how, with safe and reproducible technique that confidently avoids intra-arterial injection, CTFESI can be performed safely irrespective of the choice of steroid. METHODS: All patients undergoing CTFESI between January 2008 and August 2018 at our centre were prospectively recruited to the study, documenting total number of injections/procedures per patient, presence of/description of complications and severity and type of steroid administered. RESULTS: Five hundred and twenty-seven patients underwent 1047 procedures (1753 individual cervical levels injected) over the study period: 1011 procedures performed with particulate steroid (triamcinolone acetonide) and 36 performed with non-particulate (dexamethasone). Only six complications were encountered, all spontaneously self-resolving without intervention and considered minor (grade 1). CONCLUSIONS: With fastidious safe technique, CTFESI can be safe, efficacious and cost-effectively administered on an outpatient basis. Predominant use of particulate steroids did not lead to any significant complications. These slides can be retrieved under Electronic Supplementary Material. |
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| ジャーナル名 | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society |
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| Pubmed追加日 | 2019/9/20 |
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| 投稿者 | Bush, Keith; Mandegaran, Ramin; Robinson, Elizabeth; Zavareh, Ali |
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| 組織名 | The London Clinic, 20 Devonshire Place, London, W1G 6BW, UK. kbsec@btconnect.com.;Department of Radiology and Diagnostic Imaging, Faculty of Medicine and;Dentistry, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada.;Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, Great Maze;Pond, London, SE1 9RT, UK.;The London Clinic, 20 Devonshire Place, London, W1G 6BW, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/31535205/ |
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