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American Journal of Physical Medicine & Rehabilitation:
Research Articles: Radiculopathy

Complications of Fluoroscopically Guided Caudal Epidural Injections

Botwin, Kenneth P. MD; Gruber, Robert D. DO; Bouchlas, Constantine G. MD; Torres-Ramos, Francisco M. MD; Hanna, Ashraf MD; Rittenberg, Joshua MD; Thomas, Santhosh A. DO

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Botwin KP, Gruber RD, Bouchlas CG, Torres-Ramos FM, Hanna A, Rittenberg J, Thomas SA: Complications of fluoroscopically guided caudal epidural injections. Am J Phys Med Rehabil 2001;80:416–424.

Objectives: To assess the incidence of complications of fluoroscopically guided caudal epidural injections.

Design: A retrospective cohort design study in which chart review was performed on patients, who presented with radiculopathy and received fluoroscopically guided caudal epidural steroid injections. All injections were performed consecutively over a 12-mo period. An independent observer reviewed medical charts, which included a 24-hr post procedure telephone call by an ambulatory surgery center nurse, who asked a standardized questionnaire about complications after the injections. Physician follow-up office notes 1 to 3 wk after injection along with epidurograms were reviewed.

Results: The charts of 139 patients, who received 257 injections, were reviewed. Complications per injection included 12 episodes of insomnia the night of the injection (4.7%), 9 transient nonpositional headaches that resolved within 24 hr (3.5%), 8 increased back pain (3.1%), 6 facial flushing (2.3%), 2 vasovagal reactions (0.8%), 2 episodes of nausea (0.8%), and 1 increased leg pain (0.4%). No dural punctures occurred.

Conclusions: No major complications occurred. The incidence of minor complications was 15.6% per injection. All reactions resolved without morbidity and no patient required hospitalization.

© 2001 Lippincott Williams & Wilkins, Inc.


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