Safety and Complications of Cervical Epidural Steroid Injections

Abstract

Serious neurologic complications following cervical transforaminal epidural steroid injections (CTFESI) and cervical interlaminar epidural steroid injections (CILESI) have been reported. For CILESI, this is caused by aberrant needle placement or space-occupying lesions, such as hematoma or abscess. For CTFESI, this is caused by embolic infarct when inadvertent intra-arterial injection of particulate steroids has occurred. Multiple safety techniques are used to mitigate the risk of these serious complications. The most common adverse events that occur following CTFESI or CILESI are procedural-related pain, steroid side effects, and vasovagal reactions, which are relatively minor and self-limited.

Keywords: Cervical radiculopathy; Complications; Corticosteroids; Epidural injection; Interlaminar; Safety; Transforaminal.