Blunt or sharp needles for transforaminal epidurals?

To the Editor: Derby et al (1) noted that in 2003 approximately half (14/29) of International Spinal Injection Society (ISIS) instructors and the majority (14/17) of poll respondents reported performing transforaminal epidural steroids injections. Do the authors have any data as to needle type (blunt vs sharp) used? If ISIS instructors persist in performing transforaminal injections with sharptipped needles, this would appear to be a resounding rejection of the recent caveats appearing in the interventional pain management literature. Furthermore, although blunt tipped needles appear to be safe for use around canine renal arteries (2), no information is available to confirm the proposition that they reduce the incidence of serious complications in humans undergoing pain procedures. At this point in time the putative benefit is pure conjecture. Whether or not using blunt needles results in an unanticipated new set of devastating injuries unique to blunt Blunt Or Sharp Needles For Transforaminal Epidurals?