What are the possible complications of cervical epidural steroid injections (ESIs)?

Updated: Aug 06, 2018
  • Author: Boqing Chen, MD, PhD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

Cervical ESIs carry similar risks, with the apparent caveat that any damage to the spinal cord at the level of the cervical spine often results in greater impairment than damage at the lumbar levels and may precipitate respiratory arrest at higher cervical levels. There is the risk of spinal cord trauma if the operator performs direct injection into the spinal cord via an interlaminar approach, a risk that is essentially absent at the lower lumbar spine, since the spinal cord terminates at the level of L2.

Cord trauma can also result from compression of the spinal cord from an epidural abscess or an epidural hematoma.

Despite these risks, most agree that complications are minimal when ESIs are performed by a physician with the proper equipment, training, and technique.


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