Table 1.
Complications reported with interlaminar cervical epidural corticosteroid injections
| Study, year | Design | Pts | Medications | Imaging | Complications |
|---|---|---|---|---|---|
| Botwin et al., 2003 [22] | Retrospective cohort study | 157 pts, 345 injections, C6–7 or C7–T1 | Triamcinolone acetonide 80 mg | FL | Overall 16.8 %: 23 Increased neck pain (6.7 %) 16 Non-positional headaches (4.6 %) 6 Insomnia (1.7 %) 6 Vasovagal reactions (1.7 %) 5 Facial flushing (1.5 %) 1 Pyrexia (0.3 %) 1 Dural puncture (0.3 %) |
| Derby et al., 2003 [24] | Retrospective survey | 4389 Injections | NA | NA | 3 Dural punctures (0.07 %) 17 Vagal symptoms (0.4 %) 3 Paraesthesia and numbness (0.07 %) |
| Goel and Pollan, 2006 [26] | Prospective cohort | 29 pts, 65 injections | NA | FL | 16.9 % headaches 21.5 % insomnia, flushing of the face, temperature 6.2 % of increased pain |
| Kwon et al., 2007 [29] | Retrospective cohort study | 76 pts, 76 injections | Triamcinolone acetonide 40 mg | FL | 2 Dural punctures (2.6 %) |
| Kranz et al., 2011 [28] | Retrospective cohort study | 50 pts, 53 injections | Betamethasone | CT | 1 Intra-thecal injection |
| Manchikanti et al., 2012 [34] | Prospective cohort study | 2376 Injections | NA | FL | 100 Intravascular placement of needle (4.2 %) 24 Dural puncture (1 %) 6 Transient nerve root irritation (0.25 %) 5 Transient spinal cord irritation (0.21 %) 16 Profuse bleeding (0.7 %) 1 Vasovagal (0.04 %) 2 Facial flushing (0.08 %) |
| Lee et al., 2012 [31] | Prospective cohort study | ~127 Injections | Dexamethasone sodium phosphate 10 mg | FL | 1 Vasovagal and syncope (0.8 %) 1 Dural puncture (0.8 %) |
| Beyaz and Eman, 2013 [21] | Retrospective cohort study | 65 pts | NA | FL | 1 Vasovagal (1.54 %) 1 Transient increase of pain (1.54 %) |
| Manchikanti et al., 2013 [33] | RCT | 120 pts, 654 injections | Betamethasone 6 mg (n = 60) | FL | 2 Subarachnoid punctures (0.3 %) 4 Intravascular penetrations (0.6 %) 5 Nerve root irritations (0.76 %) 1 Pain lasting 1 week (0.15 %) |
| Lee et al., 2014 [30] | Retrospective cohort study | 143 pts | Triamcinolone acetonide 40 mg | 1 Itching sensations 1 Facial flushing 1 Dry mouth 1 Erectile dysfunction |
|
| Manchikanti et al., 2014 [32] | RCT | 120 pts, 688 injections | Betamethasone 6 mg (n = 60) | FL | 6 Subarachnoid punctures (0.3 %) 10 Intravascular penetrations (0.6 %) 3 Nerve root irritations (0.76 %) 1 Pain lasting 1 week (0.15 %) |
CT computed tomography, FL fluoroscopy, NA not available, pts patients, RCT randomised controlled trial