An update on technical and safety practice patterns of interlaminar epidural steroid injections

• DOI: 10.1016/j.inpm.2023.100371
• Publication Date: 2023-11-29T10:00:20Z
• Authors: Berkenesh Gebrekr...; Razvan Turcu; Dana Kotler; Ashley E. Gureck; Alec L. Meleger
• Keywords: Epidural steroid injection; Radicular pain; Methylprednisolone acetate; Interventional pain management; Private practice

Interlaminar epidural steroid injections (ILESIs) are mainstay in the management of low back, neck and radicular pain a commonly performed procedure United States. Our survey aims to provide an update practice patterns ILESIs among interventional physicians. We distributed 91-item nationwide private academic physicians who perform (ESIs). The was via REDCap with series questions inquiring about current practices from March 2021 2022. Cross sectional data responses specific ILESI-related were captured synthesized. Of 103 complete responses, 96 (cervical, 87.5 %; thoracic, 82.3 lumbar 99 %). Nearly all surveyed utilize fluoroscopy (98.1 %) over other modalities like MRI ultrasound. For CIESIs, dexamethasone preferred (52.4 methylprednisolone (23.7 %); converse true for LIESIs which (44.2 (32.6 majority providers performing ILESI's (91.7 Tuohy/Weiss needle while only small fraction Quincke (7.2 Sedation more varied half (47.6 offering medications. Furthermore, great continue use contrast (97.9 CIESIs (89.6 suggests that despite updated consensus recommendations, variability continues exist procedural patterns. Highlighting areas variable adherence safety guidelines can assist what is emphasized generation future evidence-based guidelines. Though our conducted context COVID-19 pandemic resultant supply chain shortages, research needed elucidate variables may factor into why proceduralists stray guideline concordant care.