The use of cervical epidural nerve blocks in the management of chronic head and neck pain

Catchlove, Richard F. H.; Braha, Richard E. D.

doi:10.1007/bf03015258

Cited by 57 publications

(34 citation statements)

References 4 publications

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“…[2][3][4]7,[12][13][14][15][16][17][18][19] These numbers are of limited clinical utility for numerous reasons. Very few studies actually focused on complications of ICESI but are incidental reports from papers that focused on technique, efficacy, or opinion.…”

Section: Discussionmentioning

confidence: 99%

“…3,7,12,20 Exact mechanisms for these are unknown, and none has been specifically studied in association with ICESI. Other minor complications mentioned in the literature include nausea and vomiting, 14 fever the night of the procedure (0.3%), 7 soreness at injection site, 21 significant self-limited hypotensive episode, 20 respiratory insufficiency, 13 24 hours of subjective upper extremity weakness, 14 insomnia during the night Increased axial neck pain 4,7 Common complaint (13.2%-6.7%) 4,7 Attributed to local soft tissue trauma 7 or large volumes 4 injected into an already tight epidural space Nonpositional headaches 7 4.6% 7 Sclerotomal referral of pain caused by soft tissue trauma and changes in vascular tone from physiologic stress (e.g., anxiety)…”

Section: Minor Complications Of Icesimentioning

confidence: 98%

“…Paresthesias after ICESI have been described as transient, 13,15,39 prolonged, or permanent (Table 6). 15 Nerve root injury sustained during insertion of the needle is one proposed mechanism.…”

Section: Major Complications Of Icesimentioning

confidence: 99%

“…Other authors have incidentally reported their complication rates as part of their efficacy trials (Table 1). 3,10,[13][14][15] Of note, multiple trials reported a complication rate of zero. 2,4,16 -18 Estimates of the overall reported complication rate varies drastically between 0% and 16.8%.…”

Section: Complications Associated With Icesimentioning

confidence: 99%

“…2,4,16 -18 Estimates of the overall reported complication rate varies drastically between 0% and 16.8%. [2][3][4]7,[12][13][14][15][16][17][18][19] It is challenging for the reader to interpret these data without further information as to how it was collected, since they were gathered from a group of heterogeneous studies where the investigators were not specifically focusing on complications. Therefore, for this review, the authors have chosen to group the information by complication and potential severity.…”

Section: Complications Associated With Icesimentioning

confidence: 99%

See 4 more Smart Citations

Complications of Interlaminar Cervical Epidural Steroid Injections

Abbasi¹,

Malhotra²,

Malanga³

et al. 2007

Spine

124

103

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There are significant limitations in the available literature discussing the complications associated with ICESI, but they strongly suggest that ICESI is a relatively safe procedure. Numerous potential adverse reactions have been associated with ICESI, with the vast majority being minor and transient in nature. However, serious complications may also result and may be technique related. Injectionists should be aware of the clinical presentations, rates, potential consequences, and appropriate techniques to avoid these complications. More studies are needed with specific focus on cervical complication rates, standardization of injection techniques, and differentiation between complications and poor efficacy. In addition, the use of a prospective randomized blinded controlled design would be beneficial.

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Section: Discussionmentioning

confidence: 99%

Section: Minor Complications Of Icesimentioning

confidence: 98%

Section: Major Complications Of Icesimentioning

confidence: 99%

Section: Complications Associated With Icesimentioning

confidence: 99%

Section: Complications Associated With Icesimentioning

confidence: 99%

See 3 more Smart Citations

Complications of Interlaminar Cervical Epidural Steroid Injections

Abbasi¹,

Malhotra²,

Malanga³

et al. 2007

Spine

124

103

View full text Add to dashboard Cite

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Spinal Injections

Leonardi

Pfirrmann

Spinal Disorders

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Outcome of cervical radiculopathy treated with periradicular/epidural corticosteroid injections: a prospective study with independent clinical review

Bush¹,

Hillier

1996

Eur Spine J

207

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This prospective study with independent clinical review was set up to monitor the clinical outcome of patients when using serial periradicular/epidural corticosteroid injection techniques in managing cervical radiculopathy. Over a 10 year period, between 1986 and 1995, a consecutive series of 68 secondary referral patients presenting with cervical radiculopathy were entered into the study. There were 57 men (84%) and 11 women (16%) of average age 47 years (range 31-65 years). The average duration of symptoms prior to presentation was 2 months (range 1-12 months). All patients apart from one had neurological signs. Of the 64 patients (94%) who underwent imaging, relevant pathology thought to correlate with the clinical presentation was demonstrated in all but one patient. Serial periradicular/ epidural corticosteroid injections were used to control pain; an average of 2.5 injections was administered per patient (range 1-6). Patients underwent a final clinical examination when their pain had remained satisfactorily under control for an average of 7 months (range 1-23 months). They subsequently were reassessed, by an independent clinician, at an average of 39 months (range 4-112 months) after initial presentation, via a telephone interview. Despite the fact that all 68 patients were potential surgical candidates, they all made a satisfactory recovery without the need for surgical intervention. Forty-eight patients (76%) did not experience any arm pain, and of the 15 patients (24%) who did, this improved from 10 to an average of 2 (range 1-4) on a 10-point pain scale. Thus, patients with cervical radiculopathy make a satisfactory recovery with serial periradicular/epidural corticosteroid injections without the need for surgical intervention.

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The use of cervical epidural nerve blocks in the management of chronic head and neck pain

Cited by 57 publications

References 4 publications

Complications of Interlaminar Cervical Epidural Steroid Injections

Complications of Interlaminar Cervical Epidural Steroid Injections

Spinal Injections

Outcome of cervical radiculopathy treated with periradicular/epidural corticosteroid injections: a prospective study with independent clinical review

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