The Spine Journal
Volume 10, Issue 5 , Pages 367-371 , May 2010

Influence of needle type on the incidence of intravascular injection during transforaminal epidural injections: a comparison of short-bevel and long-bevel needles

  • Matthew Smuck, MD

      Affiliations

    • Department of Orthopaedic Surgery, Stanford University Spine Center, Redwood City, CA 94063, USA
    • Corresponding Author InformationCorresponding author. Department of Orthopaedic Surgery, Stanford University, 450 Broadway St., Redwood City, CA 94083, USA. Tel.: (650) 725-9323.
    • ,
  • Andrew J. Yu, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48108, USA
    • ,
  • Chi-Tsai Tang, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48108, USA
    • ,
  • Eric Zemper, PhD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48108, USA

Received 16 December 2008 ,Revised 2 November 2009 ,Accepted 25 December 2009.

References 

  1. Friedly J, Chan L, Deyo R. Increases in lumbosacral injections in the Medicare population: 1994 to 2001. Spine. 2007;32:1754–1760
  2. Botwin KP, Gruber RD, Bouchlas CG, et al. Complications of fluoroscopically guided transforaminal lumbar epidural injections. Arch Phys Med Rehabil. 2000;81:1045–1050
  3. Scanlon GC, Moeller-Bertram T, Romanowsky SM, Wallace MS. Cervical transforaminal epidural steroid injections: more dangerous than we think?. Spine. 2007;32:1249–1256
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  8. Smuck M, Fuller BJ, Yoder B, Huerta J. Incidence of mixed epidural and vascular injection during lumbosacral transforaminal epidural injections. Spine J. 2007;7:79–82
  9. Sullivan WJ, Willick SE, Chira-Adisai W, et al. Incidence of intravascular uptake in lumbar spinal injection procedures. Spine. 2000;25:481–486
  10. Smuck M, Fuller BJ, Chiodo A, et al. Accuracy of intermittent fluoroscopy to detect intravascular injection during transforaminal epidural injections. Spine. 2008;33:E205–E210
  11. Nelson J. Letter to the editor Re: Blunt needles. International Spine Intervention Society Newsletter. 2006;5:58–60
  12. Akins EW, Hawkins IF, Mladinich C, et al. The blunt needle: a new percutaneous access device. AJR Am J Roentgenol. 1989;152:181–182
  13. Heavner JE, Racz GB, Jenigiri B, et al. Sharp versus blunt needle: a comparative study of penetration of internal structures and bleeding in dogs. Pain Pract. 2003;3:226–231
  14. Bogduk N. Sharp vs. blunt needles. International Spine Intervention Society White Paper. Interventional Spine. 2005;5:7–13
  15. Derby R, Baker R, Dreyfuss P, Weinstein SM. Cervical radicular pain: transforaminal vs interlaminar steroid injections. SpineLine (NASS Publication). 2004;5:16–21
  16. Manchikanti L. Cervical epidural steroid injection with intrinsic spinal cord damage. Spine. 1999;24:1170–1172
  17. Derby R, Lee SH, Kim BJ, et al. Complications following cervical epidural steroid injections by expert interventionalists in 2003. Pain Physician. 2004;7:445–449
  18. Huntoon MA. Anatomy of the cervical intervertebral foramina: vulnerable arteries and ischemic neurologic injuries after transforaminal epidural injections. Pain. 2005;117:104–111

 FDA device/drug status: not applicable.

 Author disclosures: MS (consulting fees, Arthrocare, Inc.; research support: investigator salary, Arthrocare, Inc., research support: staff/materials, Arthrocare, Inc.).

PII: S1529-9430(10)00002-1

doi: 10.1016/j.spinee.2009.12.018

The Spine Journal
Volume 10, Issue 5 , Pages 367-371 , May 2010

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