BACKGROUND Chronic lower back pain with or without radiculopathy represents an important medical, social, and economic problem. Many treatment modalities and techniques, including surgery and epidural administration of steroids, have been used to manage this pain. Hypertonic saline, which has been used as an adjunct to percutaneous epidural adhesiolysis, can also be injected via a transforamina...

Ra and Min (1) painstakingly have described the optimal angle of needle insertion for fluoroscopically guided transforaminal epidural injection of L5. Unfortunately, this potentially increases further complications related to lumbar transforaminal epidural injections with the safe triangle approach (2).Clearly, the literature undeniably shows that the safe triangle approach may not be safe and ...

AIM Laboratory training models are essential for developing and refining treatment skills before the clinical application of surgical and invasive procedures. A simple simulation model is needed for young trainees to learn how to handle instruments, and to perform safe lumbar transforaminal epidural injections. Our aim is to present a model of a fresh cadaveric sheep lumbar spine that simulates...

Spinal headache is an occasional, but painful complication of epidural injection procedures due to dural puncture that allows leakage of CSF from the thecal sac, thereby reducing intracranial pressure. In the event of failure of conservative management, (e.g. abdominal binder, fluids, acetaminophen), an epidural blood patch is often used. This case report describes a patient with spinal headach...

To the Editor: Recently, I was asked to co-author a review of the scientific evidence for, or against, the use of epidural steroid injections to treat pain. Although there have been many studies published over the years showing efficacy for interlaminar epidural injections, none met the criteria for our report because most were not randomized and none evaluated injections using fluoroscopy. On ...

Transforaminal epidural steroid injections are provided frequently for patients with lumbar radiculopathy, having demonstrated efficacy and safety. We present a patient who developed methicillin-resistant Staphylococcus aureus epidural abscess 11 days after a transforaminal epidural steroid injection. The abscess required surgical intervention and intravenous vancomycin. Fortunately, the patien...

BACKGROUND In recent years, transforaminal epidural injections have emerged as an alternative to interlaminar and caudal epidural steroid injections. The rationale for utilizing transforaminal epidural injections has been described for diagnostic as well as therapeutic purposes. The evidence for lumbar transforaminal epidural steroid injections in managing lumbar nerve root pain is strong, wher...

OBJECTIVE The objective of this paper is to review the literature of cervical transforaminal injections, resulting complications, and to suggest a safe technique. METHODS A systematic review of the literature was performed. Both the MEDLINE and EMBASE databases were searched for any article relating to cervical epidural injections, cervical transforaminal injections, and complications relatin...

Vertebral osteomyelitis (VO) is a rare, slowly progressing disease that often causes neuromuscular complications. Epidural block non-surgical treatment used in patients with radicular pain to deliver drugs the epidural space; it generally known be safe method, but can occasionally cause infection. Herein, we present rare case of VO severe complications developed patient who underwent lumbar tra...

This case report describes the successful treatment of chronic headache from intracranial hypotension with bilateral transforaminal (TF) lumbar epidural blood patches (EBPs). The patient is a 65-year-old male with chronic postural headaches. He had not had a headache-free day in more than 13 years. Conservative treatment and several interlaminar epidural blood patches were previously unsuccessf...