Particulate or Non-Particulate Steroids for Lumbar Transforaminal Injections - 2017 Update

Fact: All particulate corticosteroid preparations have been implicated in rare cases of paraplegia, whereas no definitive evidence exists of paraplegia resulting from injection of non-particulate steroids. Studies directly comparing the effectiveness of particulate and non-particulate steroids largely show no differences between the two, with respect to relief of pain, restoration of function, or rate of spine surgery. There is no evidencebased rationale for routine use of particulate steroids in lumbar transforaminal injections, given the increased risk of paraplegia.