Article
Medicine, General & Internal
You-Ri Kang, Tai-Seung Nam, Byeong C. Kim, Jae-Myung Kim, Soo Hyun Cho, Kyung Wook Kang, Kang-Ho Choi, Joon-Tae Kim, Seong-Min Choi, Seung-Han Lee, Man-Seok Park, Myeong-Kyu Kim
Summary: This study investigated the clinical, laboratory, and radiological features of meningitis after lumbar epidural steroid injection (M-ESI) without accompanying spinal infection. Seven patients with M-ESI were identified and all presented with headache and fever. Cerebrospinal fluid analysis showed abnormalities and radiologic findings included sulcal hyperintensity and pneumocephalus. Symptoms improved quickly with treatment and no neurological sequelae were observed.
Article
Multidisciplinary Sciences
Sowon Jang, Jungheum Cho, Eugene Lee, Yusuhn Kang, Myung Joo Kang, Young Wook Choi, Joon Woo Lee
Summary: This study investigated the local retention of steroid-loaded PLGA microspheres in epidural injections using a rabbit model. The results showed that the PLGA group had higher steroid retention than the TA group in the first week after injection, but most of the steroids disappeared after 2 weeks in both groups.
SCIENTIFIC REPORTS
(2022)
Article
Rehabilitation
Paul M. Kitei, David E. Surrey, Jeremy I. Simon, David S. Stolzenberg
Summary: The epidural space can be accessed for corticosteroid injections to treat radicular pain either through an interlaminar or transforaminal approach. If conventional access is not desired or contraindicated, a transarticular approach can be considered. This approach has been described using computed tomography guidance in the cervical spine, but not fluoroscopic guidance. This article describes a fluoroscopy-guided cervical transarticular approach to the epidural space and reviews the literature on computed tomography-guided techniques. The risks of transarticular epidural injections are low when performed carefully to avoid direct contact with critical structures.
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION
(2023)
Article
Health Care Sciences & Services
Peter B. Smulowitz, A. James O'Malley, Lawrence Zaborski, J. Michael McWilliams, Bruce E. Landon
Summary: Even within the same hospital, there is significant variation in hospital admission rates among emergency department physicians, despite little change in predicted admission risk based on patient characteristics. This suggests that strategies targeting physician decision making could be effective in modifying admission rates.
Article
Oncology
Jinhai Huo, Young-Rock Hong, Kea Turner, Cheng Chen, Yi Guo, Diana J. Wilkie, Jiang Bian
Summary: The study found significant geographic variation in the use of palliative care among metastatic lung cancer patients in the USA, with increasing trends over the years. The median time from cancer diagnosis to first palliative care visit also varied geographically.
SUPPORTIVE CARE IN CANCER
(2021)
Article
Medicine, General & Internal
Jae Young Lee, Jun Woo Kim, Yong Jae Na, Taikon Kim, Seung Hoon Han
Summary: This case report describes a subcutaneous and epidural abscess following epidural injection, caused by Enterococcus faecalis. The patient experienced worsened symptoms after treatment, but with correct diagnosis and treatment, significant improvement was achieved in both clinical condition and serum biomarkers. This case highlights the importance of considering comorbid conditions and steroid usage history in patients undergoing epidural injections.
Article
Otorhinolaryngology
Franklin M. Wu, Ruben Ulloa, Ido Badash, Kevin Hur
Summary: This study examines the patterns of intranasal corticosteroid (INCS) prescriptions for Medicare beneficiaries in the United States from 2013 to 2017. The results show an increase in INCS prescriptions during this period, with variation in cost per beneficiary for different medications. The study also finds a correlation between the number of otolaryngology providers and claims per state, as well as a moderate correlation between average annual temperature and INCS claims per beneficiary in each state.
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY
(2023)
Article
Medicine, General & Internal
Minsoo Kim, Soyeon Cho, Yeonji Noh, Daehun Goh, Hee-Jeong Son, Jin Huh, Seong-Sik Kang, Byeongmun Hwang
Summary: This study examined the effects of epidural steroid injection (ESI) on pain scores and walking distance in patients with lumbar central spinal stenosis. The results showed that moderate stenosis patients had decreased pain scores and increased walking distance two weeks after the ESI, while severe stenosis patients had decreased pain scores with no significant change in walking distance. Patients with moderate stenosis achieved better outcomes than those with severe stenosis.
Article
Clinical Neurology
Min Cheol Chang, Donghwi Park
Summary: The study assessed the reliability, quality, and usefulness of the most-viewed YouTube videos of epidural steroid injection (ESI), finding that the majority of videos had low quality, even those produced by hospitals or physicians. Efforts to improve the reliability and quality of medical content on YouTube are necessary.
JOURNAL OF PAIN RESEARCH
(2021)
Article
Medicine, General & Internal
Minsoo Kim, Jiwon Bak, Daehun Goh, Jangho Bae, Kiyoung Shin, Hee-Jeong Son, Jin Huh, Seong-Sik Kang, Byeongmun Hwang
Summary: This study evaluated the effect of TFESI on pain scores and walking distance in patients with lumbar foraminal spinal stenosis. It found that TFESI significantly reduced pain scores and increased walking distance in patients after 4 weeks of treatment. However, patients with moderate disease severity had better pain relief outcomes and satisfaction compared to those with severe disease severity.
Article
Anesthesiology
Yeon Ju Kim, Hyungtae Kim, Ha-Jung Kim, Won Uk Koh, Jiyoung Kim, Young-Jin Ro
Summary: This study describes a novel technique using color Doppler to predict the spread of epidural space during ultrasound-guided interlaminar epidural steroid injection (ILESI). The results showed that color Doppler had good predictive efficacy in ultrasound-guided ILESI. Ultrasound-guided ILESI has the advantages of no radiation exposure and contrast medium requirement.
Article
Anesthesiology
Christin A. Tiegs-Heiden, Ajay A. Madhavan, Felix E. Diehn, Vance T. Lehman, Naveen S. Murthy
Summary: This retrospective study demonstrates the presence of contrast flow in the retrodural space of Okada during transforaminal epidural steroid injections. The uptake of contrast in this space is relatively uncommon and likely underrecognized. It is crucial for providers to be familiar with this flow pattern and adjust needle positioning to ensure steroid delivery to the epidural space.
Review
Clinical Neurology
E. J. A. Verheijen, C. A. Bonke, E. M. J. Amorij, C. L. A. Vleggeert-Lankamp
Summary: Epidural steroid injections (ESI) show greater improvements in leg pain and functional status for sciatica patients compared to epidural placebo injections in the short term. However, there is no significant difference in back pain outcomes. Some studies suggest ESI can reduce analgesic intake with low complication rates.
EUROPEAN SPINE JOURNAL
(2021)
Article
Clinical Neurology
Tara Shelby, Emily S. Mills, Hyunwoo P. Kang, Andy Ton, Raymond J. Hah, Ram K. Alluri
Summary: This study found no association between preoperative ESI within 30 days before surgery and postoperative infection in patients undergoing posterior cervical surgery.
Article
Anesthesiology
Nishan Bingham, Raymon Dhall, Michael Montuori, Kristoffer Padjen, Christopher Gharibo, Lisa Doan
Summary: This study surveyed pain medicine physicians in the United States to provide an update on current practices for transforaminal and interlaminar epidural steroid injections (ESI). While there seems to be a trend towards following guidelines, there are still variations in ESI practice.