Safety of CT-Guided Lumbar Nerve Root Infiltrations Analysis of a Two-Year Period

Gossner, Johannes

doi:10.15274/inr-2014-10082

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…68 Concerning epidural injections, imaging modalities used for guidance include fluoroscopy, CT and MRI. 16,17,50,51,[69][70][71] Ultrasound guidance with navigation systems can be used for periradicular (i.e. transforaminal) injections.…”

Section: Epidural Injectionsmentioning

confidence: 99%

A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies

Filippiadis

Kelekis

2016

BJR

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Low back pain and neuralgia due to spinal pathology are very common symptoms debilitating numerous patients with peak prevalence at ages between 45 and 60 years. Intervertebral discs and facet joints act as pain sources in the vast majority of the cases. Diagnosis is based on the combination of clinical examination and imaging studies. Therapeutic armamentarium for low back pain and neuralgia due to intervertebral discs and/or facet joints includes conservative therapy, injections, percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments which can be performed as outpatient procedures. In cases of facet joint syndrome, they include, apart from injections, neurolysis with radiofrequency/cryoablation, MR-guided high-intensity focused ultrasound and percutaneous fixation techniques. In case of discogenic pain, apart from infiltrations, therapeutic techniques can be classified in to two main categories: decompression (mechanical, thermal, chemical) techniques and biomaterials implantation/disc cell therapies. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. This article will report clinical and imaging findings for each pathology type and the association with treatment decision. In addition, we will describe in detail all possible treatment techniques for low back pain and neuralgia, and we will report recently published results of these techniques summarizing the data concerning safety and effectiveness as well as the level of evidence. Finally, we will try to provide a rational approach for the therapy of low back pain and neuralgia by means of minimally invasive imaging-guided percutaneous techniques.

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Section: Epidural Injectionsmentioning

confidence: 99%

A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies

Filippiadis

Kelekis

2016

BJR

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“…We are not aware of any data comparing interlaminar to transforaminal CT‐guided lumbar puncture; however, we have used this approach (without thecal puncture) for periradicular epidural steroid injections without major complications. Researchers described use of this method for periradicular injections in 2 series of 143 and 231 patients and reported no major complications, although we view these reports cautiously because the thecal sac was not punctured in these studies . A transforaminal approach has been recently reported in a pediatric SMA cohort, and it is unclear whether smaller foramina in pediatric patients puts them at higher risk of complications.…”

mentioning

confidence: 96%

Transforaminal lumbar puncture for intrathecal nusinersen administration

et al. 2018

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“…Patients were treated under sterile conditions and placed in the prone position on the table of the CT scanner (BrightSpeed, GE Healthcare, Chicago, IL, USA). During PRI treatment, the needles were positioned lateral to the midline at the level of the affected nerve root via a transforaminal approach [ 17 , 18 ]. The medication was rinsed around the affected nerve root ( Figure 2 ).…”

Section: Methodsmentioning

confidence: 99%

How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain

Lindemann,

Hölzl,

Böhle

et al. 2023

Diagnostics

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The aim of this study was to research the influence of psychological confounders on patient-reported outcomes (PROs) after lumbar infiltration therapies of periradicular infiltrations (PRI). Patients who underwent PRI in a single center between June 2018 and December 2019 were included. PRI was performed in patients with predominantly unilateral lumbar radiculopathy which existed for at least 6 weeks based on single-level nerve root compression (caused by a herniated disc, stenosis of the lateral recess, or neuroforamen), confirmed by morphological imaging. The numeric pain rating scale (NRS) for back pain (BP) and leg pain (LP) and the Oswestry Disability Index (ODI) were assessed preinterventionally, on the first day (only NRS) and at 6 weeks, and then 3, 6, and 12 months postinterventionally. The minimally clinically important difference (MCID) served as the threshold for the therapeutic effectiveness evaluation. The health-related quality of life (SF-36) was recorded preinterventionally and after 12 months. Based on the Hospital Anxiety and Depression Scale, the patients were dichotomized into depressed or nondepressed and anxious or nonanxious. Categorical data were evaluated using Fisher’s exact test, and continuous data were evaluated using Student’s t test. Separate linear mixed models were built to estimate the effect of anxiety or depression on repeatedly measured PROs following PRI. Data were analyzed using SPSS software. The analysis included 102 patients. Most mean baseline PROs were significantly worse in anxious or depressed patients than in nonanxious or nondepressed patients: Anxiety NRS-BP (p = 0.007), ODI (p < 0.001); Depression NRS-BP (p = 0.026), NRS-LP (p < 0.001), ODI (p < 0.001). All patients showed a clinically meaningful reduction in pain and functional improvement over a 12-month follow-up. There was no significant difference in the estimated overall mean PRO between all patients (p > 0.05). In conclusion, anxiety and depression are associated with worse PROs before and after PRI. However, patients with underlying depression or anxiety can expect a similar gain in PRO compared to patients without depressive or anxious symptoms.

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Safety of CT-Guided Lumbar Nerve Root Infiltrations Analysis of a Two-Year Period

Cited by 7 publications

References 16 publications

A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies

A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies

Transforaminal lumbar puncture for intrathecal nusinersen administration

How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?—A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain

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