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Arch Phys Med Rehabil. 2005 Feb;86(2):277-83.

Complications and side effects of cervical and lumbosacral selective nerve root injections.

Author information

1
The Orthopedic Clinic Association, Scottsdale, AZ 85260, USA. cwhuston@cox.net

Abstract

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.

PMID:
15706554
DOI:
10.1016/j.apmr.2004.02.018
[Indexed for MEDLINE]

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