Neuraxis Ischemic Injury
DEFINITION Broadly speaking, the spinal cord is at risk of ischemic injury under any circumstances in which the supply of oxygen or nutrients is insufficient to meet metabolic demands. Thus,…
Local Anesthetic Neurotoxicity and Cauda Equina Syndrome
DEFINITION Recent clinical experience and experimental data define a rather narrow therapeutic index for local anesthetics with respect to their potential for neurotoxic injury.1 The actual risk varies based on…
Neuraxis Mechanical Injury
DEFINITION This chapter defines mechanical neuraxis injury as fulfilling one of two criteria. The first, direct mechanical injury, encompasses those circumstances in which a needle or catheter directly damages the…
Complications Associated with Chronic Steroid Use
The right dose differentiates a poison and a remedy. —Paracelsus (1493–1541) Marc A. Huntoon and Halena M Gazelka OVERALL SCOPE GLUCOCORTICOSTEROID PHYSIOLOGY HYPOTHALAMIC-PITUITARY-ADRENAL AXIS SUPRESSION Scope Pathophysiology Risk Factors Diagnosis…
Myotoxicity
DEFINITION The performance of regional anesthesia may cause muscle injury by several mechanisms. Ischemia from an occlusive tourniquet such as during an intravenous regional anesthetic may produce muscle damage, but…
Complications Associated with Discography and Intradiscal Treatment Techniques
COMPLICATIONS ASSOCIATED WITH PROVOCATIVE DISCOGRAPHY Because of its nonspecific features, the diagnosis of discogenic pain is not easily made by clinical means alone. Useful tools in the search for the…
Complications Associated with Transforaminal Injections
DEFINITION Transforaminal injections are injections delivered into an intervertebral foramen of the vertebral column. The target is typically the spinal that lies in the foramen. When used for diagnostic purposes,…
Complications Associated with Superior Hypogastric and Ganglion Impar Blocks
DEFINITION AND SCOPE The relevant anatomy and technique for superior hypogastric and ganglion impar blocks have been well described, but only limited observational data point to the usefulness of these…
An Overview of Risk Analysis
SOME BACKGROUND ON RISK A more complete understanding of risk necessarily flows from the development of an accurate definition of the term risk. One dictionary definition of risk is “possibility…
The Role of Nerve Localization Techniques in Safety
Levels of evidence: Ia, evidence from meta-analysis; III, evidence from well-designed, nonexperimental descriptive studies such as comparative studies or case reports; IV, expert opinion.Table modified from Neal JM. Ultrasound-guided regional…
