CardioVascular and Interventional Radiology

, Volume 34, Issue 6, pp 1288–1295 | Cite as

Histopathological Alterations after Single Epidural Injection of Ropivacaine, Methylprednizolone Acetate, or Contrast Material in Swine

  • Maria-Chrysanthi Kitsou
  • Georgia Kostopanagiotou
  • Konstantinos Kalimeris
  • Demetrios Vlachodimitropoulos
  • Konstantinos Soultanis
  • Chrysanthi Batistaki
  • Alexis KelekisEmail author
Laboratory Investigation



The consequences from the injection of different types of drugs in the epidural space remains unknown. Increasing evidence suggests that localized inflammation, fibrosis, and arachnoiditis can complicate sequential epidural blockades, or even epidural contrast injection. We investigate the in vivo effect of epidural injections in the epidural space in an animal model.

Materials and Methods

A group of ten male adult pigs, five punctures to each at distinct vertebral interspaces under general anesthesia, were examined, testing different drugs, used regularly in the epidural space (iopamidol, methylprednisolone acetate, ropivacaine). Each site was marked with a percutaneous hook wire marker. Histological analysis of the epidural space, the meninges, and the underlying spinal cord of the punctured sites along with staining for caspase-3 followed 20 days later.


The epidural space did not manifest adhesions or any other pathology, and the outer surface of the dura was not impaired in any specimen. The group that had the contrast media injection showed a higher inflammation response compared to the other groups (P = 0.001). Positive staining for caspase-3 was limited to <5% of neurons with all substances used.


No proof of arachnoiditis and/or fibrosis was noted in the epidural space with the use of the above-described drugs. A higher inflammation rate was noted with the use of contrast media.


Imaging Pain management Palliation Spine/nervous system Experimental IR Neurointerventions 



This work was funded by the National and Kapodistrian Athens University through the Special Research Account (ELKE) of the 2nd Department of Anesthesiology, Medical School, Attikon University Hospital, University of Athens, Athens, Greece.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2011

Authors and Affiliations

  • Maria-Chrysanthi Kitsou
    • 1
  • Georgia Kostopanagiotou
    • 1
  • Konstantinos Kalimeris
    • 1
  • Demetrios Vlachodimitropoulos
    • 2
  • Konstantinos Soultanis
    • 3
  • Chrysanthi Batistaki
    • 1
  • Alexis Kelekis
    • 4
    Email author
  1. 1.2nd Department of Anesthesiology-Pain Unit, School of Medicine, Attikon University HospitalUniversity of AthensAthensGreece
  2. 2.Department of Forensic Medicine, School of MedicineUniversity of AthensAthensGreece
  3. 3.1st Department of Orthopaedics, School of Medicine, Attikon University HospitalUniversity of AthensAthensGreece
  4. 4.2nd Radiology Department, Attikon University HospitalUniversity of AthensAthensGreece

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