Adverse events associated with fluoroscopically guided lumbosacral transforaminal epidural XXXX injections.

@entity1 @entity1671 @entity228 @entity22 @entity158 @entity479 @entity10 @entity10145
BACKGROUND CONTEXT: Although the types and incidence of adverse events (AEs) associated with transforaminal epidural @entity479 injection (TFESI) have been described, no study has used a systematic standardized questionnaire to solicit AEs from @entity1 to capture an accurate range and incidence of complications. PURPOSE: The aim was to systematically identify the types and incidence of AEs associated with TFESI. Additionally, this study evaluated demographic and clinical factors that may predict a higher risk of an AE. STUDY DESIGN/SETTING: This was a retrospective cohort study from a multiphysician academic PM_R clinic. @entity1 SAMPLE: @entity1 , aged 19 to 89, who underwent a fluoroscopically guided TFESI for @entity10145 @entity158 between 2004 and 2007 were included. OUTCOME MEASURES: The relationship of AEs with gender, age, trainee presence, @entity479 type, preprocedure visual analog scale (VAS) @entity158 score, systolic blood pressure, fluoroscopy time, and @entity228 injectate volume was analyzed. METHODS: Adverse event data were collected using a survey both immediately and at 24 to 72 hours after TFESI. Statistical analysis was performed using the chi-square, Fisher exact, or Wilcoxon rank sum two-sided tests. Logistic regression analysis was also performed. C.P. is the owner of Rehabilitation Institute of Chicago Physiatric Log _ Analysis System computer software. RESULTS: In 1,295 consecutive @entity1 undergoing 2,025 TFESI procedures, immediate AEs and delayed AEs occurred after 182 (9.2%) and 305 (20.0%) injections, respectively. The most common immediate AEs were: vasovagal reaction (4.2%) and interrupted procedure from intravascular flow (1.7%). Common delayed AEs included: @entity158 exacerbation (5.0%), injection site soreness (3.9%), @entity10 (3.9%), @entity1671 (1.8%), and @entity22 (1.6%). Significant associations were identified between AEs and gender, age, preprocedure VAS, @entity479 type, and fluoroscopy time. Trainee involvement in the procedure did not impact the complication rate. CONCLUSIONS: Fluoroscopically guided lumbosacral TFESI is associated with a similar rate of minor AEs both immediately and 24 to 72 hours after procedure that are typical of other axial @entity228 injections. Permanent AEs were not found in this sample. The most common AEs associated with TFESI include vasovagal episodes, procedure interruption from intravascular flow, @entity158 exacerbation, injection site soreness, @entity10 , and @entity22 .
