Complications of injections in conservative treatment of degenerative spine disease: a prospective unicentric study

Abstract

Background Spinal injection has been an accepted part of conservative therapy for degenerative diseases. The drugs used can cause side effects and severe complications. The aim of this study was to determine the occurrence of general side effects (GSE) and complications when performing consecutive different types of spinal injections and to evaluate pain reduction. Methods Prospective data evaluation of patients with degenerative spine disease at hospital admission, discharge, and six and 12 weeks after discharge. All patients received a specific injection protocol depending on their symptoms and radiological findings. The injections performed were dorsal sacroiliac joint injections, perineural injections, epidural interlaminar and epidural periradicular injections, and facet joint injections. Potential complications were categorized and recorded as GSE and complications. In addition, the Numerical Analog Scale (NAS) for pain, the Oswestry Disability Index (ODI) were evaluated. Results Forty-eight patients were enrolled. There were 282 spinal injections performed. A total of 131 common treatment-related events were recorded. Depending on the type of injection, transient pain at the injection site (32.4–73.5%), radiating pain (9.4–34.7%), and nerve root irritation (2–18.4%) were the most common. One complication with postpuncture syndrome occurred with epidural-interlaminar injection. No persistent neurologic deficits occurred. The highest rate of GSE was observed with periradicular injections (relative frequency (RF) = 0.8), followed by epidural-interlaminar injections (RF = 0.65), least frequently with FJ injections (RF = 0.32). From the time of admission to discharge, NAS scores were significantly decreased and ODI score significantly improved at discharge (p < 0.001), but relapse occurred at the 12-week follow-up. Conclusions Various consecutive spinal injections for conservative treatment of degenerative spine diseases are safe and lead to a decrease in pain and improvement in quality of life. GSE are common, but not persistent. Although complications are rare, they can have serious consequences for the patient.

Injective Treatments for Sacroiliac Joint Pain: A Systematic Review and Meta-analysis

“…The failure rate was 26% in steroid injections and 14% in PRP injections. Two articles about SIJ steroid injections reported a high rate (19 and 50%) [ 21 , 22 ] of unspecified complications, while the other studies reported a lower number of complications: overall, the complication rate was 1% in steroid injections and 1% in PRP injections. The used scores were heterogeneous (Fig.…”

Comparison of Efficacy between Transforaminal Epidural Steroid Injection Technique without Contrast versus with Contrast in Lumbar Radiculopathy: A Prospective Longitudinal Cohort Study

“…The administration of contrast media during ESI can lead to serious adverse effects, including anaphylactic shock in patients with allergies to contrast agents and contrast-induced acute kidney injury in patients with pre-existing renal conditions [ 28 ]. Furthermore, our study suggests that performing ESI without contrast media leads to decreased radiation exposure and shorter operation time for patients.…”

Lumbar Facet Joint Injection: A Review of Efficacy and Safety

“…Voelker 등( 54 )은 주사 방법에 따라 부작용 발생률이 다르다고 보고했다. 일시적인 두통은 경막 외 추궁판간 주사 그룹에서 가장 흔하게 나타났으며(13.5%), 후관절 주사 그룹에서 가장 드물게 나타났다(1.8%).…”