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Published on: August 7, 2018
Intradiscal flow during a transforaminal epidural steroid injection
1Advanced Pain Management, Virginia Beach, VA, USA. levid@cox.net
Pain Medicine (Malden, Mass.)
|June 16, 2010
Summary
During lumbar epidural steroid injections, needles can inadvertently enter extruded disc material. This case highlights the risk of intradiscal flow with large lateral disc extrusions during transforaminal epidural steroid injections.
Area of Science:
- Pain management
- Neurosurgery
- Radiology
Background:
- Transforaminal epidural steroid injections are common for lumbar pain.
- Large lateral disc extrusions with cephalad migration present unique challenges.
Observation:
- A case report details an inadvertent intradiscal flow during a lumbar L4/5 transforaminal epidural steroid injection.
- Contrast flow indicated needle entry into extruded disc material, filling the L4/5 disc.
Findings:
- Needle entry into disc material is possible even with significant disc herniation.
- Intradiscal flow can occur during transforaminal epidural steroid injections.
Implications:
- This case underscores the importance of careful needle placement in transforaminal epidural steroid injections.
- Awareness of potential complications like intradiscal flow is crucial for procedural safety.
- Further research may explore imaging techniques to minimize this risk.
