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

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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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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Keywords

  • Epidural
  • Steroid
  • Injections
  • Particulate
  • Non-particulate
  • Radiculopathy