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Interlaminar and Caudal Epidural Steroid Injections for the Treatment of Pain in the Rehabilitation Patient

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Comprehensive Pain Management in the Rehabilitation Patient

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Abstract

Epidural steroid injections can be a part of a comprehensive, multimodal treatment plan for spine-related pain. Interlaminar and caudal approaches to the spine have been used for many years and have a good safety and efficacy profile. Providers should be aware of contraindications, risks, and benefits of these procedures to appropriately refer for or perform these procedures.

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References

  1. Kaye AD, Manchikanti L, Abdi S, et al. Efficacy of epidural injections in managing chronic spinal pain: a best evidence synthesis. Pain Physician. 2015;18(6):E939–E1004.

    Article  PubMed  Google Scholar 

  2. Robecchi A, Capra R. Hydrocortisone (compound F); first clinical experiments in the field of rheumatology. Minerva Med. 1952;43(98):1259–63.

    CAS  PubMed  Google Scholar 

  3. Martin BI, Turner JA, Mirza SK, Lee MJ, Comstock BA, Deyo RA. Trends in health care expenditures, utilization, and health status among US adults with spine problems, 1997–2006. Spine (Phila Pa 1976). 2009;34(19):2077–84. doi:10.1097/BRS.0b013e3181b1fad1.

    Article  PubMed  Google Scholar 

  4. Manchikanti L, Boswell MV, Singh V, et al. Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2009;12(4):699–802.

    Article  PubMed  Google Scholar 

  5. Work Loss Data Institute. Official disability guidelines (ODG). http://www.worklossdata.com/. Accessed 2016.

  6. Arden NK, Price C, Reading I, et al. A multicentre randomized controlled trial of epidural corticosteroid injections for sciatica: the WEST study. Rheumatology (Oxford) 2005;44(11):1399–1406. doi: kei028 [pii].

    Google Scholar 

  7. Jacobs S, Pullan PT, Potter JM, Shenfield GM. Adrenal suppression following extradural steroids. Anaesthesia. 1983;38(10):953–6.

    Article  CAS  PubMed  Google Scholar 

  8. Mendoza-Lattes S, Weiss A, Found E, Zimmerman B, Gao Y. Comparable effectiveness of caudal vs. trans-foraminal epidural steroid injections. Iowa Orthop J. 2009;29:91–6.

    PubMed  PubMed Central  Google Scholar 

  9. Rathmell JP, Benzon HT, Dreyfuss P, et al. Safeguards to prevent neurologic complications after epidural steroid injections: consensus opinions from a multidisciplinary working group and national organizations. Anesthesiology. 2015;122(5):974–84. doi:10.1097/ALN.0000000000000614.

    Article  CAS  PubMed  Google Scholar 

  10. Manchikanti L, Abdi S, Atluri S, et al. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. part II: guidance and recommendations. Pain Physician. 2013;16(2 Suppl):S49–283.

    PubMed  Google Scholar 

  11. Kim D, Brown J. Efficacy and safety of lumbar epidural dexamethasone versus methylprednisolone in the treatment of lumbar radiculopathy: a comparison of soluble versus particulate steroids. Clin J Pain. 2011;27(6):518–22. doi:10.1097/AJP.0b013e31820c53e0.

    Article  PubMed  Google Scholar 

  12. Cifu D, Kaelin D, Miller M, et al., editors. Braddom’s physical medicine & rehabilitation. 5th ed. Philadelphia, PA: Elsevier; 2016.

    Google Scholar 

  13. Slipman CW, Shin CH, Patel RK, et al. Etiologies of failed back surgery syndrome. Pain Med 2002;3(3):200–214; discussion 214–7. doi:10.1046/j.1526-4637.2002.02033.x.

  14. Franklin GM. American Academy of Neurology. Opioids for chronic noncancer pain: a position paper of the American Academy of Neurology. Neurology. 2014;83(14):1277–84. doi:10.1212/WNL.0000000000000839.

    Article  CAS  PubMed  Google Scholar 

  15. Deyo RA, Von Korff M, Duhrkoop D. Opioids for low back pain. BMJ. 2015;350:g6380. doi:10.1136/bmj.g6380.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Poiraudeau S, Rannou F, Revel M. Functional restoration programs for low back pain: a systematic review. Ann Readapt Med Phys 2007;50(6):425–-429, 419–24. doi: S0168-6054(07)00123-7 [pii].

    Google Scholar 

  17. Poulain C, Kerneis S, Rozenberg S, Fautrel B, Bourgeois P, Foltz V. Long-term return to work after a functional restoration program for chronic low-back pain patients: a prospective study. Eur Spine J. 2010;19(7):1153–61. doi:10.1007/s00586-010-1361-6.

    Article  PubMed  PubMed Central  Google Scholar 

  18. El-Yahchouchi CA, Plastaras CT, Maus TP, et al. Adverse event rates associated with transforaminal and interlaminar epidural steroid injections: a multi-institutional study. Pain Med. 2015; doi:10.1111/pme.12896.

    Article  Google Scholar 

  19. Epstein NE. The risks of epidural and transforaminal steroid injections in the spine: commentary and a comprehensive review of the literature. Surg Neurol Int. 2013;4(Suppl 2):S74–93. doi:10.4103/2152-7806.109446.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Pountos I, Panteli M, Walters G, Bush D, Giannoudis PV. Safety of epidural corticosteroid injections. Drugs R D. 2015;16(1):19–34. doi:10.1007/s40268-015-0119-3.

    Article  CAS  PubMed Central  Google Scholar 

  21. Horlocker TT, Wedel DJ, Rowlingson JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American society of regional anesthesia and pain medicine evidence-based guidelines (third edition). Reg Anesth Pain Med. 2010;35(1):64–101.

    Article  CAS  PubMed  Google Scholar 

  22. Manchikanti L, Kaye AD, Manchikanti K, Boswell M, Pampati V, Hirsch J. Efficacy of epidural injections in the treatment of lumbar central spinal stenosis: a systematic review. Anesth Pain Med. 2015;5(1):e23139. doi:10.5812/aapm.23139.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Manchikanti L, Singh V, Cash KA, Pampati V, Datta S. Fluoroscopic caudal epidural injections in managing post lumbar surgery syndrome: two-year results of a randomized, double-blind, active-control trial. Int J Med Sci. 2012;9(7):582–91. doi:10.7150/ijms.4672.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Friedly JL, Comstock BA, Turner JA, et al. A randomized trial of epidural glucocorticoid injections for spinal stenosis. N Engl J Med. 2014;371(1):11–21. doi:10.1056/NEJMoa1313265.

    Article  CAS  PubMed  Google Scholar 

Recommended Reading

  • Atlas of Image-Guided Spinal Procedures, 1st Edition, Furman

    Google Scholar 

  • Braddom’s Physical Medicine & Rehabilitation, 5th Edition, Cifu

    Google Scholar 

  • Interventional Spine: An Algorithmic Approach, 1st Edition, Slipman

    Google Scholar 

  • Guidelines: SIS, ASRA, and ODG

    Google Scholar 

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Author information

Authors and Affiliations

  1. Physical Medicine & Rehabilitation, The University of Texas at Austin I Dell Medical School, 1400 North IH-35, Suite 2.230, Austin, TX, 78701, USA

    Joseph William D.O., M.P.H

  2. Texas Orthopedics Sports & Rehabilitation, 4700 Seton Center Parkway, Suite 200, Austin, TX, 78759, USA

    Ai Mukai M.D.

Authors
  1. Joseph William D.O., M.P.H
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  2. Ai Mukai M.D.
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Corresponding author

Correspondence to Joseph William D.O., M.P.H .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Brown University, Warren Alpert Medical School, Providence, USA

    Alexios Carayannopoulos DO, MPH

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William, J., Mukai, A. (2017). Interlaminar and Caudal Epidural Steroid Injections for the Treatment of Pain in the Rehabilitation Patient. In: Carayannopoulos DO, MPH, A. (eds) Comprehensive Pain Management in the Rehabilitation Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-16784-8_35

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  • DOI: https://doi.org/10.1007/978-3-319-16784-8_35

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-16783-1

  • Online ISBN: 978-3-319-16784-8

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