How can the risk of complications from epidural steroid injections (ESIs) be minimized?

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

Answer

The complications of ESIs can probably be averted by using fluoroscopic guidance, contrast enhancement to avoid vascular uptake, DSA, nonparticulate corticosteroid, and a test dose of local anesthetic before injection of corticosteroid. In the lumbar spine, transforaminal ESI using the Kambin triangle is recommended to avoid needle injury to the radiculomedullary artery or nerve root.


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