Lumbar epidural steroid injections indications contraindications risks and benefits

Epidural steroid injections are generally very safe, but there are some rare potential complications. One of the most common risks is for the needle to go too deep and cause a hole in the dura, the tissue that surrounds the spinal cord and nerve roots. When this occurs spinal fluid can leak out through the hole and cause a headache . This headache can be treated with bedrest, or with a blood patch. A blood patch involves drawing some blood from the vein and the injecting it over the hole in the dura. The blood forms a seal over the hole and prevents any further fluid from leaking out.

Radiculopathy occurs when something irritates a spinal nerve—say a “slipped disc” causing a pinched nerve. This is also called sciatica . There are resident stem and other cells in the local tissues everywhere in our body. Many live around blood vessels. These are obviously also present in the disc and nerves in the epidural space and they usually play an important role in suppressing inflammation and repairing damage. We know, based on a copious in vitro (lab) data, that the high-dose steroids used in epidural injections can kill these cells. So the progression of the series of epidural steroid injections looks a little something like this:

Lumbar epidural steroid injections indications contraindications risks and benefits

lumbar epidural steroid injections indications contraindications risks and benefits

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