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Ideal Corticosteroid Choice for Epidural Steroid Injections: A Review of Safety and Efficacy

  • Interventional Pain Management (DJ Kennedy, Section Editor)
  • Published:
Current Physical Medicine and Rehabilitation Reports Aims and scope Submit manuscript

Abstract

Spine pathology and pain are common. Epidural injections for radicular pain are a common treatment option. While effective for certain populations, these injections have been associated with rare but significant complications including paralysis. The mechanism of injury is felt to be an embolic event following an injection of non-soluble particulate corticosteroids inadvertently into an artery that perfuses the spinal cord or brain. This dire complication has varying risks based on the anatomic considerations of a given route of injection and the corticosteroid utilized. This article will review the proposed mechanism of injury, anatomy principles of the routes of epidural injections, and the solubility and efficacy research on the different commonly utilized corticosteroid options.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Orthopedics, Stanford University, 450 Broadway St, Redwood City, CA, 94063, USA

    Byron Schneider, Neal Varghis & David J. Kennedy

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  1. Byron Schneider
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  2. Neal Varghis
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  3. David J. Kennedy
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Correspondence to Byron Schneider.

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This article is part of the Topical Collection on Interventional Pain Management.

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Schneider, B., Varghis, N. & Kennedy, D.J. Ideal Corticosteroid Choice for Epidural Steroid Injections: A Review of Safety and Efficacy. Curr Phys Med Rehabil Rep 3, 151–158 (2015). https://doi.org/10.1007/s40141-015-0086-1

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