scholarly journals METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS EPIDURAL ABSCESS AFTER TRANSFORAMINAL EPIDURAL STEROID INJECTION

2004 ◽  
Vol 2;7 (4;2) ◽  
pp. 269-272 ◽  
Author(s):  
Abdallah Kabbara
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Epidural Abscess ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Methicillin Resistant ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid

scholarly journals Vertebral Osteomyelitis: A Potentially Catastrophic Outcome after Lumbar Epidural Steroid Injection

2008 ◽  
Vol 5;11 (10;5) ◽  
pp. 693-697 ◽  
Author(s):  
Thomas T. Simopoulos
Keyword(s):  
Staphylococcus Aureus ◽  
Back Pain ◽  
Spinal Stenosis ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Methicillin Resistant ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Epidural Steroid

Background and Objective: Epidural steroid injections are commonly used to palliate the symptoms of spinal stenosis. Deep tissue infection is a known potential complication of these injections. There have been no previous published cases of osteomyelitis without epidural abscess after such injections. We present a case in an elderly patient who presented only with persistent axial low back pain following a lumbar epidural steroid injection (LESI). We emphasize early patient evaluation, consideration of infectious predisposing factors, sterile technique, and skin disinfectant. Design: Open-label case report. Case description: A 77-year-old diabetic male with a history of radicular pain related to lumbar spinal stenosis was treated successfully several years prior with a series of lumbar epidural steroid injections (LESI) and was re-treated with LESIs for recurrent symptoms. Following his second epidural injection, he presented with back pain and induration at the injection site without fever or neurological deficits. Urgent magnetic resonance imaging (MRI) revealed a soft tissue abscess extending close to the epidural space around the corresponding L4/L5 vertebral level. The patient recovered after incision and drainage of the abscess which was associated with an osteomyelitis of the L4 and L5 vertebral spine. The causative organism was methicillin-resistant Staphylococcus Aureus. Conclusion: This case demonstrates that even with proper aseptic techniques, immune-compromised patients who are colonized with an aggressive micro-organism may develop a potentially catastrophic infectious complication if subtle persistent symptomatic complaints are not promptly and carefully evaluated. Key words: osteomyelitis, epidural steroid injection, methicillin-resistant staphylococcus aureus (MRSA)

scholarly journals Spinal Cord Infarction after Cervical Transforaminal Epidural Steroid Injection: Case Report and Literature Review

2017 ◽  
Vol 9 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Jangsup Moon ◽  
Hyung-Min Kwon
Keyword(s):  
Spinal Cord ◽  
Steroid Injection ◽  
Cervical Radiculopathy ◽  
Epidural Steroid Injection ◽  
Spinal Cord Infarction ◽  
Catastrophic Event ◽  
History Of ◽  
Transforaminal Epidural Steroid Injection ◽  
Active Rehabilitation ◽  
Epidural Steroid

Introduction: Transforaminal epidural steroid injection (TFESI) is a widely used nonsurgical procedure in the treatment of patients with radiculopathy. It is efficacious in relieving pain, but a number of complications are being reported. Recently, increasing frequency of major complications, such as spinal cord infarction and cerebral infarction, has been reported with the use of a particulate steroid within fluoroscopic-guided procedures. Methods: We report a 49-year-old man with a history of chronic cervical radiculopathy, who experienced a devastating complication after TFESI. Results: After 2 min of regular TFESI, the patient abruptly experienced muscle weakness in both upper extremities and within 5 min the patient became quadriplegic. Despite active rehabilitation, the patient remained bed-ridden 4 years after the catastrophic event. To our knowledge, this is the first reported case of spinal cord infarction that occurred after TFESI in Korea. Conclusion: Considering the risk of dreadful complications, which appear in an unpredictable manner, TFESI with fluoroscopic guidance should be done only with a nonparticulate steroid.

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