Table 3.
Complications reported with transforaminal lumbar epidural corticosteroid injections
| Study, year | Design | Pts | Medications | Imaging | Complications |
|---|---|---|---|---|---|
| Botwin et al., 2000 [53] | Retrospective cohort study | 207 pts, 322 injections | Either betamethasone 9–12 mg or methylprednisolone 80 mg | FL | 10 Non-positional headaches (3.1 %) 8 Increased back pain (2.4 %) 2 Increased leg pain (0.6 %) 4 Facial flushing (1.2 %) 1 Vasovagal reaction (0.3 %) 1 Increased blood sugar (258 mg/dL) in an insulin-dependent patient with diabetes mellitus (0.3 %) 1 Intraoperative hypertension (0.3 %) |
| Ahadian et al., 2011 [62] | Prospective randomised study | 98 pts, 98 injections | Dexamethasone 4, 8 or 12 mg | FL | 1 Pain at injection site 5 Vascular uptake 6 Paraesthesia during procedure |
| Karaman et al., 2011 [57] | Prospective cohort study | 562 pts, 1305 injections | Triamcinolone acetonide | FL | 97 Vascular penetration (7.4 %) 8.7 % vasovagal episodes 5 Transient erectile dysfunction (0.9 %) 5 Facial flushing (0.9 %) |
| McGrath et al., 2011 [59] | Retrospective cohort study | 1667 pts, 3964 injections | NA | FL | 42 Increased pain 6 Numbness 9 Pain at injection site |
| Manchikanti et al., 2012 [34] | Prospective cohort study | 1310 Injections | NA | FL | 104 Intravascular placement of needle (7.9 %) 16 Transient nerve root irritation (4.6 %) 8 Profuse bleeding (1 %) 1 Vasovagal (0.08 %) 2 Facial flushing (0.15 %) |
| Cansever et al., 2012 [63] | Prospective cohort study | 153 pts | Methylprednisolone 40 mg | FL | 2 Discitis |
| Wewalka et al., 2012 [69] | Cohort study | 37 pts, 65 injections | Triamcinolone 40 mg | CT | 3 Transient weakness 14 Increased low back pain 2 Low blood pressure post-injection |
| Koh et al., 2013 [65] | RCT | 53 pts | Triamcinolone 20 mg | FL | 1 Burning at injection site (1.9 %) |
| Manson et al., 2013 [58] | Retrospective cohort study | 91 pts, 106 injections | Triamcinalone 40 mg | FL | 2 Vasovagal episodes |
| Hong et al., 2014 [56] | Prospective cohort study | 239 pts, 249 injections | Dexamethasone 5 mg and mepivacaine 3 mL | FL | 6 Intradiscal injection |
| Manchikanti et al., 2014 [67] | RCT | 120 pts, 601 injections | Betamethasone 3 mg | FL | 28 Intravascular infiltrations (4.6 %) 9 Nerve root irritations (1.5 %) |
| Kraiwattanapong et al., 2014 [66] | Prospective cohort study | 38 pts, 72 injections | Methylprednisolone 80 mg | FL | 3 Worsening of leg pain |
| Ploumis et al., 2014 [61] | Prospective cohort study | 20 pts, L4–S1 | Betamethasone 9 mg | FL | 2 Vasovagal episodes (10 %) |
| Tauheed et al., 2014 [68] | RCT | 60 pts | Methylprednisolone 60 mg | FL | 3 Transient paraesthesia of nerve distribution |
CT computed tomography, FL fluoroscopy, NA not available, pts patients, RCT randomised controlled trial