Ct guided epidural steroid injection lumbar

As the hip is a ball and socket joint, formed by the upper thigh bone (femur) and pelvis (acetabulum), incongruity of one or both bones may result in abutment (impingement), causing cartilage wear and tear (degeneration), ultimately premature osteoarthritis. Not surprisingly, this condition is known as femoroacetabular impingement , or “FAI”. As FAI may result in decreased hip range of motion, increased stress is places on the pelvis, thus predisposing the pubic symphysis also to degeneration, commonly referred to as osteitis pubis (OP) .

The clinical history, physical examination, and imaging is consistent with extensive destruction of the lumbar spine extending over three vertebral segments with associated epidural abcess necessitating surgical decompression and fusion. An epidural abscess may present rapidly with neurological compromise. Prognosis improves with prompt decompression, but only 18% of patients with frank abscess and 23% of patients with paralysis completely recover after decompression.

Hadjipavlou et al report in their Level 4 study that leukocyte counts were elevated in % of spondylodiscitis cases. The erythrocyte sedimentation rate was elevated in all cases of epidural abscess.

The article by Harrington et al states that the surgical indications for an epidural abcess include: unsuccessful antibiotic treatment after 6 weeks, vertebral deformity or instability, neurological deficit, MRI showing > 50% compression of thecal sac, and depressed host immune response.

Illustration A shows radiographs following anterior debridement, corpectomy, fibular strut grafting, and Kaneda instrumentation.

The benefits from the first shot only lasted 2 weeks. The second and third set of injections lasted about 90 days. In November, I was ready to have surgery. My EMG and nerve conduction tests proved that the nerves were "sleeping" before I was. After another MRI, the neurosurgeon said I was a candidate for surgery but I was not able to get the endoscopic type surgery that is less invasive. I would have an incision about 6-8" long. Along with removing the herniation, they would have to increase the size of the hole where the nerve roots were going through.

There is also a small risk of an allergic reaction to iodinated contrast when it is injected. This is not a risk for contrast that is swallowed. It is not possible to predict whether you will be allergic to iodinated contrast, and even if you have had it before and not had an allergic reaction, this does not mean you will not have one the next time you have a contrast injection. The staff at the hospital or radiology practice are well trained to deal with allergic reactions should they arise. It is important to make the radiographer or nurse aware of any other allergies that you may have before having the injection. If you are allergic to other foods or drugs, it increases the chance that you will have an allergic reaction to iodinated contrast.

A recent study 22   analyzed the predictive value of the symptoms and outcomes of patients with spinal epidural abscess. The duration of pain or radiculopathy location of abscess, and degree of granulation tissue do not appear to affect the outcome of the disease as long as the condition is treated in a timely manner. The authors of this study suggest that surgery provides a good outcome when patients' cord symptoms (bowel and bladder dysfunction, paresis, or “plegia”) are present for fewer than 72 hours, when extent of abscess (the degree of thecal sac compression) is less than 50 percent, and when patients are younger than 60 years of age ( Table 3 ) . However, these authors did not address possible outcomes in patients with the same criteria who were treated medically. 21

Ct guided epidural steroid injection lumbar

ct guided epidural steroid injection lumbar

There is also a small risk of an allergic reaction to iodinated contrast when it is injected. This is not a risk for contrast that is swallowed. It is not possible to predict whether you will be allergic to iodinated contrast, and even if you have had it before and not had an allergic reaction, this does not mean you will not have one the next time you have a contrast injection. The staff at the hospital or radiology practice are well trained to deal with allergic reactions should they arise. It is important to make the radiographer or nurse aware of any other allergies that you may have before having the injection. If you are allergic to other foods or drugs, it increases the chance that you will have an allergic reaction to iodinated contrast.

Media:

ct guided epidural steroid injection lumbarct guided epidural steroid injection lumbarct guided epidural steroid injection lumbarct guided epidural steroid injection lumbarct guided epidural steroid injection lumbar