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In Vivo SiRNA Transfection and Gene Knockdown in Spinal Cord via Rapid Noninvasive Lumbar Intrathecal Injections in Mice
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International Pain and Spine Intervention Society Emergency Protocols: Intra-arterial Injection

Nathaniel M Schuster1, Stephan Klessinger2, Patrick H Waring3

  • 1Center for Pain Medicine, Department of Anesthesiology, University of California San Diego Health System, La Jolla, CA, USA.

Interventional Pain Medicine
|June 19, 2026
PubMed

This protocol discusses the risks associated with inadvertent intra-arterial injection during spine interventions, including stroke, seizure, spinal cord infarction, and paralysis. It highlights the dangers of particulate steroid embolism and arterial vasospasm, particularly during transforaminal injections. The protocol focuses on immediate recognition, termination of the procedure, activating stroke protocols, neurologic assessment, airway management, and rapid transfer for advanced neurologic care.

Keywords:
EmergenciesEmergency protocolInterventional pain proceduresIntra-arterial injectionRisk mitigation

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