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Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis
Published on: October 17, 2025
[Lumbar epidural and foraminal injections: update].
1Service de Radiologie Ostéo-articulaire, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75010 Paris, France. marc.wybier@lrb.aphp.fr
Journal De Radiologie
|September 4, 2010
Summary
Fluoroscopy-guided lumbar spine injections can cause paralysis due to arterial ischemia. Prior surgery and specific steroid use, like prednisolone acetate, may increase risks of this serious complication.
Area of Science:
- Neurology
- Radiology
- Interventional Pain Management
Background:
- Fluoroscopy-guided lumbar spine injections are common procedures.
- Potential complications include neurological deficits such as paralysis.
- Understanding risk factors is crucial for patient safety.
Observation:
- A review of 12 cases (2002-2008) of immediate paralysis following fluoroscopy-guided lumbar spine injections.
- Magnetic Resonance (MR) imaging revealed spinal cord ischemia of arterial origin in affected patients.
- Common factors included prior lumbar surgery and specific injection approaches.
Findings:
- Prior lumbar spine surgery appears to increase the risk of paraplegia, potentially due to scar tissue.
- Different injection routes (transforaminal, interlaminar, juxta-zygapophyseal) were used, particularly in patients with previous surgery.
- The frequent use of prednisolone acetate in France may contribute to cases due to its propensity for macro-aggregate formation and subsequent embolization.
Implications:
- These findings highlight the potential risk of spinal cord ischemia and paralysis after lumbar spine injections.
- Identifying patients with prior surgery and considering alternative steroid formulations may mitigate risks.
- Further research into the mechanism of arterial embolization is warranted to improve procedural safety.
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