This review, covering a timespan of almost a century, attempts to answer five pressing questions: (1) Are intraspinal steroid therapies eVective for back pain or radicular syndromes? (2) Do epidural injections remain confined to the epidural space? (3) Are presently prescribed steroid formulations neurotoxic? (4) What are the risks of epidural steroid injection? (5) What information should be g...

Spinal epidural abscess (SEA) was first described in the medical literature in 1761 and represents a severe infection of the epidural space requiring emergent neurosurgical intervention to avoid permanent neurologic deficits [1]. Epidural abscess is a rare condition, with a reported incidence of 1 ± 2 / 10.000 of all patients admitted to hospital [2]. It is generally thought to be a "very rare,...

This review, covering a timespan of almost a century, attempts to answer five pressing questions: (1) Are intraspinal steroid therapies eVective for back pain or radicular syndromes? (2) Do epidural injections remain confined to the epidural space? (3) Are presently prescribed steroid formulations neurotoxic? (4) What are the risks of epidural steroid injection? (5) What information should be g...

We report the clinical and imaging findings in the cases of two children who initially presented with back pain related to epidural AVF in the cervicothoracic spine. Both lesions were of particular interest because of their exclusive epidural and paraspinal venous drainage and the presence of the prominent venous pouches in the epidural space. Angiography revealed that one was multifocal and of...

We report a rare case of cervical spinal epidural abscess due to Klebsiella pneumoniae. While the most likely pathogen is Staphylococcus aureus, 2.5% of CNS infections have been attributed to Klebsiella pneumoniae. The source of infection in this case is suspected to be from cervical vertebra osteomyelitis/discitis that expanded to epidural space. Prompt drainage of the abscess by decompression...

Loss of air pressure resistance leads to a high rate (25.7%) of inaccurate needle-tip placement in the posterior soft tissues of the back during lumbar epidural steroid administration employing a 20-gauge Tuohy needle. Imaging and epidurogram are essential for confident identification of the lumbar epidural space to enable accurate location of steroid administration. Studies assessing efficacy ...

A 52-year-old male presented with acute purulent discitis and epidural abscess of the cervical spine manifesting as neck pain and slight fever, followed by sudden onset of quadriparesis. Magnetic resonance (MR) imaging showed a low-signal-intensity area in the C6/7 disc space and epidural space ventral to the spinal cord with peripheral enhancement. Surgical exploration using an anterior approa...

Low back pain is an important medical, social, and economic problem involving approximately 15% to 39% of the population. Of the numerous therapeutic interventions available for treatment of chronic low back pain, including surgery, epidural administration of corticosteroids is one such intervention commonly used. Several approaches available to access the lumbar epidural space are the caudal, ...

Neuromodulation with spinal cord stimulation is a proven, cost effective treatment for the management of chronic radicular low back pain from failed low back surgery syndrome and other neuropathic pain conditions. The traditionally instructed method for percutaneous spinal cord stimulator lead placement promotes the use of a "loss of resistance" technique under anteroposterior fluoroscopic guid...

BACKGROUND Uncertainty remains over the risk of epidural space infection after neuraxial blockade in the presence of systemic sepsis. For many years, we have provided epidural analgesia to children undergoing thoracotomy for the decortication of parapneumonic empyemas. Following recent publications asserting that epidural analgesia is absolutely contraindicated in this situation, we audited our...