Complications of Interventional Therapy for the Management of Low Back Pain

  • Eric J. Wang
  • Cameron Kluth
  • Dermot P. Maher


Interventional treatments available to address chronic low back pain have grown in their variety, but every procedure has associated risks. Complications from interventional procedures can be divided into three broad categories: complications associated with all interventional techniques, complications arising from the employed medications, and complications unique to certain procedures. For interventional pain procedures, the most relevant medications include local anesthetics, steroids, and contrast agents. Each of these medications can cause patient harm when overdose occurs, and at times, their inherent physical properties may also cause complications. Notwithstanding patient-related factors, the risk of any interventional pain procedure relates to the anatomical site involved and the type of instrumentation required. The practitioner must be aware of common and rare complications in context of all of these factors in order to implement measures to avoid them, as well as quickly identify and manage them should they occur. In addition, pain management physicians must be aware of all these possible complications so that an accurate risk-benefit discussion can be held with patients during the consent process. Further, patient care cannot truly be optimized unless practices are constantly refined to reduce the risk of possible complications.


Low back pain Local anesthetic systemic toxicity (LAST) Contrast agent allergy Corticosteroids Particulate steroids Non-particulate steroids Epidural steroid injections (ESI) Facet nerve blocks Medial branch blocks Radiofrequency ablation (RFA) Sacroiliac joint injections (SIJ) Intradiscal procedures Intrathecal drug delivery systems (IDDS) Vertebroplasty and kyphoplasty 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Eric J. Wang
    • 1
  • Cameron Kluth
    • 1
  • Dermot P. Maher
    • 2
  1. 1.Department of Anesthesiology and Critical Care MedicineJohns Hopkins HospitalBaltimoreUSA
  2. 2.Department of Anesthesia and Critical Care MedicineJohns Hopkins Hospital and Sibley Memorial HospitalWashington, DCUSA

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