OBJECTIVE: To determine the incidence of complications and side effects of cervical and lumbosacral selective nerve root injections (SNRIs). DESIGN: Prospective, nonrandomized controlled trial of consecutive patients with independent interviews for immediate, 1-week, and 3-month follow-ups. SETTING: Tertiary, academic spine center. PARTICIPANTS: Of 160 patients eligible for SNRI, 151 underwent 306 SNRIs (study group). Sixty patients who had not undergone any intervention served as the control group. INTERVENTIONS: Diagnostic and therapeutic fluoroscopically guided cervical and lumbosacral SNRIs. Lidocaine (Xylocaine) was used in the diagnostic injections and a mixture of lidocaine and betamethasone was used in the therapeutic injections. MAIN OUTCOME MEASURES: Complications and side effects experienced during the procedure were recorded by the interventionalist. Side effects and complications experienced immediately, 1 week, and 3 months after injection were determined through independent interviews using a questionnaire format. The control group was independently interviewed using the same questionnaire. RESULTS: There were no major complications, such as death, paralysis, spinal nerve injury, infection, or allergic reaction, during the study. Ninety-one percent of subjects had no side effects during the procedure. A positive response on interview was reported by 39.4% of the study subjects immediately after the procedure. Lumbosacral SNRI side effects were as follows: increased pain at the injection site (17.1%); increased radicular pain (8.8%); lightheadedness (6.5%); increased spine pain (5.1%); nausea (3.7%); nonspecific headache (1.4%); and vomiting (0.5%). Immediate side effects from cervical SNRI were as follows: increased pain at injection site (22.7%); increased radicular pain (18.2%); lightheadedness (13.6%); increased spine pain (9.1%); nonspecific headache (4.5%); and nausea (3.4%). At the 1-week interview, comparison of the study and control groups showed statistical significance for the following: pain at injection site, cervical ( P =.001) and lumbar ( P =.005); nonspecific headache, cervical ( P =.019); and nonspinal headache, cervical ( P =.002). At 3 months, 2 subjects complained of increased neck pain and 1 reported heartburn and fluid retention. Two lumbar SNRI subjects were lost to follow-up. CONCLUSIONS: There were no major complications with cervical and lumbosacral SNRIs, although various minor side effects occurred.
OBJECTIVE: To determine the incidence of complications and side effects of cervical and lumbosacral selective nerve root injections (SNRIs). DESIGN: Prospective, nonrandomized controlled trial of consecutive patients with independent interviews for immediate, 1-week, and 3-month follow-ups. SETTING: Tertiary, academic spine center. PARTICIPANTS: Of 160 patients eligible for SNRI, 151 underwent 306 SNRIs (study group). Sixty patients who had not undergone any intervention served as the control group. INTERVENTIONS: Diagnostic and therapeutic fluoroscopically guided cervical and lumbosacral SNRIs. Lidocaine (Xylocaine) was used in the diagnostic injections and a mixture of lidocaine and betamethasone was used in the therapeutic injections. MAIN OUTCOME MEASURES: Complications and side effects experienced during the procedure were recorded by the interventionalist. Side effects and complications experienced immediately, 1 week, and 3 months after injection were determined through independent interviews using a questionnaire format. The control group was independently interviewed using the same questionnaire. RESULTS: There were no major complications, such as death, paralysis, spinal nerve injury, infection, or allergic reaction, during the study. Ninety-one percent of subjects had no side effects during the procedure. A positive response on interview was reported by 39.4% of the study subjects immediately after the procedure. Lumbosacral SNRI side effects were as follows: increased pain at the injection site (17.1%); increased radicular pain (8.8%); lightheadedness (6.5%); increased spine pain (5.1%); nausea (3.7%); nonspecific headache (1.4%); and vomiting (0.5%). Immediate side effects from cervical SNRI were as follows: increased pain at injection site (22.7%); increased radicular pain (18.2%); lightheadedness (13.6%); increased spine pain (9.1%); nonspecific headache (4.5%); and nausea (3.4%). At the 1-week interview, comparison of the study and control groups showed statistical significance for the following: pain at injection site, cervical ( P =.001) and lumbar ( P =.005); nonspecific headache, cervical ( P =.019); and nonspinal headache, cervical ( P =.002). At 3 months, 2 subjects complained of increased neck pain and 1 reported heartburn and fluid retention. Two lumbar SNRI subjects were lost to follow-up. CONCLUSIONS: There were no major complications with cervical and lumbosacral SNRIs, although various minor side effects occurred.
Authors: David J Kennedy; Byron Schneider; Ellen Casey; Joshua Rittenberg; Bryan Conrad; Matthew Smuck; Christopher T Plastaras Journal: Pain Med Date: 2013-10-04 Impact factor: 3.750
Authors: K P Schellhas; S R Pollei; B A Johnson; M J Golden; J A Eklund; R S Pobiel Journal: AJNR Am J Neuroradiol Date: 2007-09-28 Impact factor: 3.825
Authors: R S Pobiel; K P Schellhas; J A Eklund; M J Golden; B A Johnson; S Chopra; P Broadbent; M E Myers; K Shrack Journal: AJNR Am J Neuroradiol Date: 2009-02-04 Impact factor: 3.825