Epidural cervical spinal steroid injection

Kenalog in blood - Derby et al. "Size and aggregation of corticosteroids used for epidural injections"

  • Depo-Medrol also formed large aggregations in the study by Tiso et al [6]
  • Celestone Soluspan formed large aggregations only in the Derby et al study  [7 ]
  • It is speculated that these large aggregates occlude smaller vessels, and thus lead to infarction .
  • Injection of methylprednisolone vs dexamethasone vs prednisolone into the vertebral artery of pigs – see summary of study here

    A recent study 22   analyzed the predictive value of the symptoms and outcomes of patients with spinal epidural abscess. The duration of pain or radiculopathy location of abscess, and degree of granulation tissue do not appear to affect the outcome of the disease as long as the condition is treated in a timely manner. The authors of this study suggest that surgery provides a good outcome when patients' cord symptoms (bowel and bladder dysfunction, paresis, or “plegia”) are present for fewer than 72 hours, when extent of abscess (the degree of thecal sac compression) is less than 50 percent, and when patients are younger than 60 years of age ( Table 3 ) . However, these authors did not address possible outcomes in patients with the same criteria who were treated medically. 21

    The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.

    Epidural cervical spinal steroid injection

    epidural cervical spinal steroid injection

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