Epidural Steroid Infiltrations in Pain Management
|
|
- Stephanie Walters
- 6 years ago
- Views:
Transcription
1 Epidural Steroid Infiltrations in Pain Management
2 Inhoudstabel 1. Introductie 2. Farmacologie 3. Infiltratie 4. Indicatie 5. Resultaten 6. Complicaties 7. Besluit - Discussie
3 1. Introductie Rugpijn hoge prevalentie socio-economische gevolgen Behandelingsplan rol van IPM? ~ concept pijngeneratoren Epidural steroid infiltration Global Health Estimates Summary Tables: World Health Organization 2014
4 2. Farmacologie - Farmacokinetiek Methylprednisolone (Depo-Medrol) Triamcinolone (Kenalog) Bethamethasone (Celestone) Preservation matter suspension suspension solution solution IV administration no no yes yes ph 3, ,5 8,5 7,5-10,5 Dexamethasone (Aacidexam) Particle size µm µm µm - >50µm Comparison with RBC Densely packed 49% 11% 31% 9% 12x RBC 12x RBC 37% 28% 31% 4% 61% 7% 10% 22% <RBC 15% 15% 67% 3% Comparison with RBC densely packed 12x RBC 12x RBC <RBC Half-life (hours) - pharmacological - biological 3 5 1, Equivalent dose (mg) 4 4 0,75 0,6 Potency - anti-inflammatory - sodium-retaining 5 0 Tiso RL, Cutler T, Catania J a., Whalen K. Adverse central nervous system sequelae after selective transforaminal block: The role of corticosteroids. Spine J. 2004;4(4): Benedetti EM, Siriwetchadarak R, Stanec J, Rosenquist RW. Epidural steroid injections: Complications and management. Tech Reg Anesth Pain Manag [Internet]. Elsevier Inc.; 2009;13(4): Collighan N, Gupta S. Epidural steroids. Contin Educ Anaesthesia, Crit Care Pain. 2009;10(1): ,
5 2. Farmacologie - Pathofysiologie McLain RF, Kapural L, Mekhail N a. Epidural steroid therapy for back and leg pain: mechanisms of action and efficacy. Spine J. 2005;5(2):
6 3. Infiltratie methode Caudaal: CESI Interlaminair: ILESI Transforaminaal: TFESI Chou et al. Subacute and chronic low back pain: Nonsurgical interventional treatment. Up To Date 2013
7 4. Indicatie Persisterende radiculopathie S/ neuropathische pijn volgens radiculair patroon KO/ neurologische uitval, gestoorde reflexen, SLR+ D/ discushernia, foraminale stenose
8 5. Resultaten DePalma M, Slipman C. Evidence-informed management of chronic low back pain with epidural steroid injections. The Spine Journal 2008; 8-1, 45-55
9 5. Resultaten LUMBAR TFESIs Referentie Patiënten Studie opzet Follow-up Resultaten Devulder LA+H+NaCl 2. LA+steroid 3. LA+H+steroid Riew LA 2. LA+steroid Karppinen LA+steroid 2. NaCl Vad LA+steroid 2. NaCl 6m 28m 3m 12m 21m Groep 3 superieur 1. 67% chirurgie 2. 28% chirurgie Groep 1 superieur Geen verschil 1. 84% beterschap 2. 48% beterschap
10 5. Resultaten Staal JB, de Bie R, et al. Injection therapy for subacute and chronic low-back pain (Review). The Cochrane Library 2011; 3, 1-53
11 5. Resultaten Staal JB, de Bie R, et al. Injection therapy for subacute and chronic low-back pain (Review). The Cochrane Library 2011; 3, 1-53
12 5. Resultaten Staal JB, de Bie R, et al. Injection therapy for subacute and chronic low-back pain (Review). The Cochrane Library 2011; 3, 1-53
13 5. Resultaten Nielens H, Van Zundert J, et al. Chronic Low Back Pain. KCE reports vol 48C, 2006
14 6. Complicaties PROCEDURE Zenuwschade Infectie / Abces Bloeding / Hematoom Vasculaire schade Transiënte blindheid Exacerbatie rugpijn Vasovagale reactie STEROIDEN Hyperglycemie Adrenale suppressie Menorragie Embolie Facial flushing Lipomatosis Myopathie Dysphonie
15 6. Complicaties PREVENTIE IPM training Risicofactoren Monitoring Geen sedatie Stabiele buikligging Steriliteit Fluoroscopie + contrast Testdosis LA Trage injectie Dexamethasone (?) Aspiratie (?) Naaldtype (?)
16 7. Besluit - Discussie Hoge prevalentie Behandelingsmogelijkheden Gelimiteerd bewijs Wereldwijd gebruik Beperkte effectiviteit Complicaties Guidelines Biopyschosociaal multimodaal behandelingsmodel met ESI als mogelijkheid in geselecteerde patiëntenpopulatie
17 Referenties Global Health Estimates Summary Tables: World Health Organization 2014 Collighan N, Gupta S. Epidural steroids. Contin Educ Anaesthesia, Crit Care Pain. 2009;10(1):1 5. McLain RF, Kapural L, Mekhail N a. Epidural steroid therapy for back and leg pain: mechanisms of action and efficacy. Spine J. 2005;5(2): Chou et al. Subacute and chronic low back pain: Nonsurgical interventional treatment. Up To Date 2013 Nielens H, Van Zundert J, et al. Chronic Low Back Pain. KCE reports vol 48C, 2006 Abdi S, Datta S, Trescot AM, Schultz DM, Adlaka R, Atluri SL, et al. Epidural steroids in the management of chronic spinal pain: a systematic review. Pain Physician. 2007;10(1): Baker R, Dreyfuss P, Mercer S, Bogduk N. Cervical transforaminal injection of corticosteroids into a radicular artery: A possible mechanism for spinal cord injury. Pain. 2003;103(1-2): Bellini M, Barbieri M. Systemic effects of epidural steroid injections. Anaesthesiol Intensive Ther [Internet]. 2013;45(2):93 8. Available from: Benedetti EM, Siriwetchadarak R, Stanec J, Rosenquist RW. Epidural steroid injections: Complications and management. Tech Reg Anesth Pain Manag [Internet]. Elsevier Inc.; 2009;13(4): Benzon HT, Chew T-L, McCarthy RJ, Benzon H a, Walega DR. Comparison of the particle sizes of different steroids and the effect of dilution: a review of the relative neurotoxicities of the steroids. Anesthesiology. DePalma MJ, Slipman CW. Evidence-informed management of chronic low back pain with epidural steroid injections. Spine J. 2008;8(1): Derby R, Lee SH, Date ES, Lee JH, Lee CH. Size and aggregation of corticosteroids used for epidural injections. Pain Med. 2008;9(2): Dreyfuss P, Baker R, Bogduk N. Comparative effectiveness of cervical transforaminal injections with particulate and nonparticulate corticosteroid preparations for cervical radicular pain. Pain Med. 2006;7(3): Manchikanti L, Abdi S, Atluri S, Benyamin RM, Boswell M V, Buenaventura RM, et al. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain Physician [Internet]. 2013;16(2 Suppl):S Available from: httmanchikanti L, Buenaventura RM, Manchikanti KN, Ruan X, Gupta S, Smith HS, et al. Effectiveness of therapeutic lumbar transforaminal epidural steroid injections in managing lumbar spinal pain. Pain Physician [Internet]. 2012;15(3):E Rosen CD, Kahanovitz N, Bernstein R, Viola K. A retrospective analysis of the efficacy of epidural steriod injections.pdf. Clin Orthop Relat Res. 1988;228: Staal J, de Bie R, de Vet H, Hildebrandt J, Nelemans P. Injection therapy for subacute and chronic low-back pain ( Review ). Cochrane Libr. 2008;(3):1 53. Watts RW, Silagy C a. A meta-analysis on the efficacy of epidural corticosteroids in the treatment of sciatica. Anaesth Intensive Care. 1995;23(5): Tiso RL, Cutler T, Catania J a., Whalen K. Adverse central nervous system sequelae after selective transforaminal block: The role of corticosteroids. Spine J. 2004;4(4):
A Survey among Texas Pain Society Physicians Regarding the Types and Dosages of Steroids Utilized Clinically in Epidural Steroid Injectates
Open Journal of Anesthesiology, 2014, 4, 291-299 Published Online November 2014 in SciRes. http://www.scirp.org/journal/ojanes http://dx.doi.org/10.4236/ojanes.2014.411042 A Survey among Texas Pain Society
More informationBritish Pain Society/Faculty of Pain Medicine (RCA) Consensus Statement on the use of Corticosteroids for Neuraxial Procedures in the UK.
British Pain Society/Faculty of Pain Medicine (RCA) Consensus Statement on the use of Corticosteroids for Neuraxial Procedures in the UK. There has been international debate relating to the use of corticosteroids
More informationClinical Policy: Selective Nerve Root Blocks and Transforaminal Epidural Steroid Injections
Clinical Policy: Selective Nerve Root Blocks and Transforaminal Epidural Steroid Injections Reference Number: PA.CP.MP.165 Effective Date: 09/18 Last Review Date: 09/18 Coding Implications Revision Log
More informationCLINICAL GUIDELINES. CMM-207: Epidural Adhesiolysis. Version Effective February 15, 2019
CLINICAL GUIDELINES CMM-207: Version 1.0.2019 Effective February 15, 2019 Clinical guidelines for medical necessity review of speech therapy services. CMM-207: CMM-207.1: Definition 3 CMM-207.2: General
More informationMechanism of severe neurologic complications after steroid epidural injections. Jean-Denis Laredo & Hervé Bard
Mechanism of severe neurologic complications after steroid epidural injections Jean-Denis Laredo & Hervé Bard Mechanism of severe neurologic complications after steroid epidural injections Different for
More informationMEDICAL POLICY EFFECTIVE DATE: 08/15/13 REVISED DATE: 07/17/14 SUBJECT: SPINAL INJECTIONS (EPIDURAL AND FACET INJECTIONS) FOR PAIN MANAGEMENT
MEDICAL POLICY SUBJECT: SPINAL INJECTIONS (EPIDURAL AND PAGE: 1 OF: 7 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases,
More informationComparing the Efficacy of Caudal Injection of Triamcinolone with Dexamethasone in Patients with Chronic Back Pain Caused by Spinal Stenosis
Journal of Basic & Clinical Medicine http://www.sspublications.org/index.php/jbcm/index Comparing the Efficacy of Caudal Injection of Triamcinolone with Dexamethasone in Patients with Chronic Back Pain
More informationHuman Serum Modifies Aggregation Properties of Commonly Used Epidural Steroids
Pain Physician 2015; 18:E1131-E1138 ISSN 2150-1149 Case Series Human Serum Modifies Aggregation Properties of Commonly Used Epidural Steroids Sayed E. Wahezi, MD, Andrew Lederman, MD, Jeffrey Algra, MD,
More informationClinical Policy: Caudal or Interlaminar Epidural Steroid Injections
Clinical Policy: Reference Number: PA.CP.MP.164 Effective Date: 09/18 Last Review Date: 09/18 Coding Implications Revision Log Description Epidural steroid injections have been used for pain control in
More informationMEDICAL POLICY EFFECTIVE DATE: 08/15/13 REVISED DATE: 07/17/14, 06/18/15, 05/25/16, 05/18/17
MEDICAL POLICY SUBJECT: SPINAL INJECTIONS (EPIDURAL AND PAGE: 1 OF: 10 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product,
More informationVariation In The Method Of Caudal Epidural Injection- A Regional Survey
ISPUB.COM The Internet Journal of Spine Surgery Volume 5 Number 2 Variation In The Method Of Caudal Epidural Injection- A Regional Survey S Haque., J Gaskin., A Uguwoke, S Karmani Citation S Haque., J
More informationAssessment of Efficacy of Fluoroscopy Guided Steroid Injection By Transforaminal Approach in Patients with Chronic Lumbosacral Radiculopathy.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 7 Ver. X (July. 2017), PP 95-99 www.iosrjournals.org Assessment of Efficacy of Fluoroscopy
More informationCigna Medical Coverage Policies Musculoskeletal Epidural Steroid Injections
Cigna Medical Coverage Policies Musculoskeletal Epidural Steroid Injections Effective January 1, 2016 Instructions for use The following coverage policy applies to health benefit plans administered by
More informationClinical Policy: Selective Nerve Root Blocks and Transforaminal Epidural Steroid Injections
Clinical Policy: Selective Nerve Root Blocks and Transforaminal Epidural Steroid Injections Reference Number: CP.MP.165 Last Review Date: 04/18 See Important Reminder at the end of this policy for important
More informationd EFFECTIVE DATE: POLICY LAST UPDATED:
Medical Coverage Policy Epidural Injections for Pain Management d EFFECTIVE DATE: 04 01 2018 POLICY LAST UPDATED: 03 20 2018 OVERVIEW Epidural injections are generally performed to treat pain arising from
More informationFluoroscopically Guided Infiltration of the Cervical Nerve Root: An Indirect Approach Through the Ipsilateral Facet Joint
Pain Physician 2014; 17:291-296 ISSN 1533-3159 Non-Randomized Study Fluoroscopically Guided Infiltration of the Cervical Nerve Root: An Indirect Approach Through the Ipsilateral Facet Joint Alexios Kelekis,
More informationMedical Affairs Policy
Medical Affairs Policy Service: Back and Nerve Pain Procedures - Radiofrequency Ablation, Facet and Other Injections PUM 250-0035-1706 Cryoablation Medial Branch Neuroablation Radiofrequency Neuroablation
More informationEPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN
UnitedHealthcare Commercial Medical Policy EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN Policy Number: PAI001 Effective Date: May 1, 2018 Table of Contents Page INSTRUCTIONS FOR USE... 1 BENEFIT
More informationAccuracy of Live Fluoroscopy to Detect Intravascular Injection During Lumbar Transforaminal Epidural Injections
Original Article Korean J Pain Vol. 2, No., 2 pissn 25-959 / eissn 29-569 DOI:.44/kjp.2.2..8 Accuracy of Live Fluoroscopy to Detect Intravascular Injection During Lumbar Transforaminal Epidural Injections
More informationEpidural Steroid Injections for Back Pain
Epidural Steroid Injections for Back Pain Policy Number: 2.01.94 Last Review: 12/2018 Origination: 12/2014 Next Review: 12/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage
More informationMedical Policy. MP Epidural Steroid Injections for Neck or Back Pain
Medical Policy BCBSA Ref. Policy: 2.01.94 Last Review: 11/15/2018 Effective Date: 11/15/2018 Section: Medicine Related Policies 7.01.87 Artificial Intervertebral Disc: Lumbar Spine 7.01.108 Artificial
More informationContractor Information. LCD Information. FUTURE Local Coverage Determination (LCD): Lumbar Epidural Injections (L33836)
FUTURE Local Coverage Determination (LCD): Lumbar Epidural Injections (L33836) Please note: Future Effective Date. Contractor Information Contractor Name Noridian Healthcare Solutions, LLC opens in new
More informationLumbar epidural steroids injections have been a well
ORIGINAL ARTICLE Efficacy and Safety of Lumbar Epidural Dexamethasone Versus Methylprednisolone in the Treatment of Lumbar Radiculopathy A Comparison of Soluble Versus Particulate Steroids David Kim, MD
More informationComments on Washington State Health Care Authority, HTA Program Key Questions for Spinal Injections
American Society of Interventional ain hysicians " The Voice of Interventional ain Management " 81 Lakeview Drive, aducah, KY 42001 Tel.: (270) 554-9412; Fax : (270) 554-8987 E-mail:asipp@asipp.org August
More informationClinical Policy: Caudal or Interlaminar Epidural Steroid Injections
Clinical Policy: Reference Number: CP.MP.164 Last Review Date: 04/18 See Important Reminder at the end of this policy for important regulatory and legal information. Coding Implications Revision Log Description
More informationSPINE SECTION. Design. Prospective clinical study.
bs_bs_banner Pain Medicine 2014; 15: 379 385 Wiley Periodicals, Inc. SPINE SECTION Original Research Article Caudal vs Transforaminal Epidural Steroid Injections as Short-Term (6 Months) Pain Relief in
More informationDATE: 25 January 2011 CONTEXT AND POLICY ISSUES
TITLE: for Pain of the Cervical and Lumbar Spine: A Review of Clinical and Cost-Effectiveness DATE: 25 January 2011 CONTEXT AND POLICY ISSUES Low back pain (LBP) affects 80% of Canadians at some point
More informationIncreased Dose of Betamethasone for Transforaminal Epidural Steroid Injections Is Not Associated with Superior Pain Outcomes at 4 Weeks
Pain Physician 2015; 18:E355-E361 ISSN 2150-1149 Retrospective Evaluation Increased Dose of Betamethasone for Transforaminal Epidural Steroid Injections Is Not Associated with Superior Pain Outcomes at
More informationClinical Policy Bulletin: Selective Nerve Root Blocks
Clinical Policy Bulletin: Selective Nerve Root Blocks Number: 0722 Policy I. Aetna considers diagnostic selective nerve root block (SNRB), also known as selective transforaminal epidural injection with
More informationSee Policy CPT/HCPCS CODE section below for any prior authorization requirements
Effective Date: 7/1/2018 Section: MED Policy No: 123 Medical Officer 7/1/18 Date Technology Assessment Committee Approved Date: 10/10; 12/15 Medical Policy Committee Approved Date: 8/94; 7/96; 8/97; 4/98;
More informationLysis of Epidural Adhesions
Medical Policy Manual Surgery, Policy No. 94 Lysis of Epidural Adhesions Next Review: September 2019 Last Review: October 2018 Effective: November 1, 2018 IMPORTANT REMINDER Medical Policies are developed
More informationA Trial of Conscience or Good Science: Compounded Analgesics SUPPLY + DEMAND = OPPORTUNITY. Learning Objectives. How We Got Here.
Learning Objectives Trial of Conscience or Good Science: Compounded nalgesics Lee. Kral, PharmD, CPS, CPE Tanya Uritsky, PharmD, CPS Wednesday, December 11, 2013 4:00 p.m. 5:00 p.m. State the risks of
More informationMEDICAL POLICY SUBJECT: SPINAL INJECTIONS (EPIDURAL AND FACET INJECTIONS) FOR PAIN MANAGEMENT
MEDICAL POLICY SUBJECT: SPINAL INJECTIONS (EPIDURAL AND PAGE: 1 OF: 10 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product
More informationEvidence based Practice Changes Spinal Injections
Evidence based Practice Changes Spinal Injections Kathryn Mueller, MD, MPH, FACOEM Professor, School of Public Health & Department of Physiatry - University of Colorado President - American College of
More informationMEDICAL POLICY SUBJECT: RADIOFREQUENCY FACET DENERVATION
MEDICAL POLICY PAGE: 1 OF: 5 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical policy criteria are not applied.
More informationDigital Subtraction Angiography Use During Epidural Steroid Injections Does Not Reliably Distinguish Artery from Vein
Pain Physician 2016; 19:255-266 ISSN 1533-3159 Narrative Review Digital Subtraction Angiography Use During Epidural Steroid Injections Does Not Reliably Distinguish Artery from Vein Ameet S. Nagpal, MD
More informationTHE TREATMENT OF LOW back pain (LBP) is controversial,
1011 ORIGINAL ARTICLE The Relationship Between Repeated Epidural Steroid Injections and Subsequent Opioid Use and Lumbar Surgery Janna Friedly, MD, Isuta Nishio, MD, PhD, Michael J. Bishop, MD, Charles
More informationInjectable corticosteroid preparations are routinely administered
ORIGINAL RESEARCH P.J. MacMahon M.J. Shelly D. Scholz S.J. Eustace E.C. Kavanagh Injectable Corticosteroid Preparations: An Embolic Risk Assessment by Static and Dynamic Microscopic Analysis BACKGROUND
More informationBehnam Hosseini, Mohammad Hossein Ataei, Sirous Momenzadeh, Reza Jalili Khoshnood, Davood Ommi
Original Article The comparison between steroid and hypertonic saline 10% with steroid in transforaminal epidural injection in patients with unilateral foraminal stenosis Behnam Hosseini, Mohammad Hossein
More informationBackground of Epidural Steroid Injections: Where Should We Go From Here?
Background of Epidural Steroid Injections: Where Should We Go From Here? Ameet Nagpal, MD, MS, MEd Assistant Professor/Clinical, Department of Anesthesiology University of Texas Health Science Center at
More informationIntravascular Flow Detection During Transforaminal Epidural Injections: A Prospective Assessment
Pain Physician 2014; 17:21-27 ISSN 1533-3159 Prospective Evaluation Intravascular Flow Detection During Transforaminal Epidural Injections: A Prospective Assessment Omar Hamman El Abd, MD 1, Joao Eduardo
More informationEffect of Addition of Epidural Ketamine to Steroid in Lumbar Radiculitis: One-Year Follow-Up
Pain Physician 2011; 14:475-481 ISSN 1533-3159 Randomized Trial Effect of Addition of Epidural Ketamine to Steroid in Lumbar Radiculitis: One-Year Follow-Up Yasser Mohamed Amr, MD From: Tanta University
More informationThe Catheter Tip Position and Effects of Percutaneous Epidural Neuroplasty in Patients with Lumbar Disc Disease During 6-Months of Follow-up
Pain Physician 2014; 17:E599-E608 ISSN 2150-1149 Retrospective Analysis The Catheter Tip Position and Effects of Percutaneous Epidural Neuroplasty in Patients with Lumbar Disc Disease During 6-Months of
More informationClinical Policy: Sacroiliac Joint Interventions for Pain Management
Clinical Policy: for Pain Management Reference Number: PA.CP.MP.166 Effective Date: 09/18 Last Review Date: 09/18 Coding Implications Revision Log Description Treatment for sacroiliac joint (SIJ) dysfunction
More informationEfficacy of epidural steroid injection in lumbar disc disease
2018; 4(3): 01-05 ISSN: 2395-1958 IJOS 2018; 4(3): 01-05 2018 IJOS www.orthopaper.com Received: 01-05-2018 Accepted: 02-06-2018 Dr. Vivian D Almeida Dr. Vinayak PG Resident, Department of Orthopaedics,
More informationEfficacy of Epidural Injections in Managing Chronic Spinal Pain: A Best Evidence Synthesis
Pain Physician 2015; 18:E939-E1004 ISSN 2150-1149 Systematic Review Efficacy of Epidural Injections in Managing Chronic Spinal Pain: A Best Evidence Synthesis Alan D. Kaye, MD, PhD 1, Laxmaiah Manchikanti,
More informationTransforaminal epidural steroid injection (TFESI) has gained
ORIGINAL ARTICLE Lumbar Transforaminal Epidural Dexamethasone A Prospective, Randomized, Double-Blind, Dose-Response Trial Farshad M. Ahadian, MD,*Þ Kai McGreevy, MD,þ and Gerhard Schulteis, PhD* Background
More informationMaximizing Safety During Spine Interventions: Technique, Steroid Selection, and Anticoagulation Management
Maximizing Safety During Spine Interventions: Technique, Steroid Selection, and Anticoagulation Management Byron J Schneider, MD, Assistant Professor PM&R Vanderbilt University Medical Center AOCPMR 2018
More informationEffect of Cervical Interlaminar Epidural Steroid Injection: Analysis According to the Neck Pain Patterns and MRI Findings
Original Article Korean J Pain 2016 April; Vol. 29, No. 2: 96-102 pissn 2005-9159 eissn 2093-0569 http://dx.doi.org/10.3344/kjp.2016.29.2.96 Effect of Cervical Interlaminar Epidural Steroid Injection:
More informationMedical Affairs Policy
Medical Affairs Policy Service: Back Pain Procedures-Epidural Injection (Caudal Epidural, Selective Nerve Root Block, Interlaminal, Transforaminal, Translaminal Epidural Injection) PUM 250-0015-1706 Medical
More informationClinical and Histological Effects of the Intrathecal Administration of Methylprednisolone in Dogs
Pain Physician 2010; 13:493-501 ISSN 1533-3159 Animal Trial Clinical and Histological Effects of the Intrathecal Administration of Methylprednisolone in Dogs Rodrigo Moreira Lima, MD 1, Lais H. Navarro,
More informationRole of Epidural Steroids in the Management of Chronic Spinal Pain: A Systematic Review of Effectiveness and Complications
Abdi et al Systematic Review of Epidural Steroids 127 Pain Physician. 2005;8:127-143, ISSN 1533-3159 A Systematic Review Role of Epidural Steroids in the Management of Chronic Spinal Pain: A Systematic
More informationEFFICACY OF TRANSFORAMINAL EPIDURAL STEROID INJECTION IN LUMBOSACRAL RADICULOPATHY
EFFICACY OF TRANSFORAMINAL EPIDURAL STEROID INJECTION IN LUMBOSACRAL RADICULOPATHY Saheel Majid 1, Dinesh K. Yadav 2, Suhail M. Vakil 3, Zameer Ali 4, Tauseef A. Bhat 5, Ayaz Ali 6, Shafaqat Rashid 7,
More informationClinical Study. Pain Physician 2018; 21:E181-E186 ISSN Younghoon Jeon, MD, PhD 1 and Saeyoung Kim, MD, PhD 2
Pain Physician 2018; 21:E181-E186 ISSN 2150-1149 Clinical Study Detection of Intravascular Injection During Cervical Transforaminal Epidural Injection: A Comparison of Digital Subtraction Angiography and
More informationSystematic Review of Therapeutic Lumbar Transforaminal Epidural Steroid Injections
Pain Physician 2009; 12:233-251 ISSN 1533-3159 Systematic Review Systematic Review of Therapeutic Lumbar Transforaminal Epidural Steroid Injections Ricardo M. Buenaventura, MD 1, Sukdeb Datta, MD 2, Salahadin
More informationFDA Warnings and Safe Use Initiatives
CDI Quality Institute Epidural Steroid Injection Guideline Thomas Gilbert, M.D., M.P.P., Damon Spitz, M.D., Blake Johnson, M.D., Kurt Schellhas, M.D. 6/8/15 working draft Over the last 15 years it has
More informationJeffrey Radecki, MD Assistant Professor Division of Rehabilitation Medicine Assistant Attending Physiatrist Weill Cornell Medical College NewYork
Jeffrey Radecki, MD Assistant Professor Division of Rehabilitation Medicine Assistant Attending Physiatrist Weill Cornell Medical College NewYork Presbyterian Hospital Miss work for >6 months 50% chance
More informationClinical Policy: Lysis of Epidural Lesions Reference Number: CP.MP.116
Clinical Policy: Reference Number: CP.MP.116 Effective Date: 07/16 Last Review Date: 07/17 Coding Implications Revision Log See Important Reminder at the end of this policy for important regulatory and
More informationEfficacy of Epidural Steroid Injections in Management of ChronicLow Back Pain.
Original article: Efficacy of Epidural Steroid Injections in Management of ChronicLow Back Pain. *Dr. Jamadar N. P, * Dr. Khade Ganesh, ** Dr. Ghuge Sandeep, * Dr. Joshi V, * Dr. Shiledar Vikram. *Dept.
More informationRetrospective cohort study of usage patterns of epidural injections for spinal pain in the US fee-for-service Medicare population from 2000 to 2014
Retrospective cohort study of usage patterns of epidural injections for spinal pain in the US fee-for-service Medicare population from 2000 to 2014 The Harvard community has made this article openly available.
More informationTHERMAL INTRADISCAL PROCEDURES
evicore healthcare Clinical Decision Support Tool Diagnostic Strategies: This tool addresses common symptoms and symptom complexes. Imaging requests for patients with atypical symptoms or clinical presentations
More informationNuances of Spinal Radiculopathy. James Mallows
Nuances of Spinal Radiculopathy James Mallows Spinal dermatomes A dermatome is an area of skin that is mainly supplied by a single spinal nerve History of dermatomes Pioneering work by Sherrington (late
More informationThe Incidence of Various Types of Systemic Reactions Related to Epidural Steroid Injections: A Prospective Observational Study
Original Article Musculoskeletal Imaging https://doi.org/10.3348/kjr.2018.19.2.301 pissn 1229-6929 eissn 2005-8330 Korean J Radiol 2018;19(2):301-310 The Incidence of Various Types of Systemic Reactions
More informationESI - Utilization Review Case Presentation
ESI - Utilization Review Case Presentation Request for ESI Hx & PE 31 y/o F parts warehouse stocker DOI: 2008 MOI: felt tightness in legs and shoulders reaching into a shelf to move a product from one
More informationMeta-Analysis. Pain Physician 2015; 18:29-36 ISSN
Pain Physician 2015; 18:29-36 ISSN 1533-3159 Meta-Analysis Digital Subtraction Angiography Versus Real- Time Fluoroscopy for Detection of Intravascular Penetration Prior to Epidural Steroid Injections:
More informationSurgical Treatment for Sacroiliac Joint Pain
Surgical Treatment for Sacroiliac Joint Pain Policy Number: 6.01.23 Last Review: 5/2014 Origination: 5/2013 Next Review: 5/2015 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will not provide
More informationCigna Medical Coverage Policies Musculoskeletal Sacroiliac Joint Injections
Cigna Medical Coverage Policies Musculoskeletal Sacroiliac Joint Injections Effective January 1, 2016 Instructions for use The following coverage policy applies to health benefit plans administered by
More informationCLINICAL GUIDELINES. CMM-203 ~ Sacroiliac Joint Injections. Version 19.0 Effective August 11, 2017
CLINICAL GUIDELINES CMM-203 ~ Sacroiliac Joint Injections Version 19.0 Effective August 11, 2017 evicore healthcare Clinical Decision Support Tool Diagnostic Strategies:This tool addresses common symptoms
More informationCLINICAL GUIDELINES. CMM-201: Facet Joint Injections/Medial Branch Blocks. Version Effective October 22, 2018
CLINICAL GUIDELINES CMM-201: Facet Joint Injections/Medial Branch Blocks Version 20.0.2018 Effective October 22, 2018 Clinical guidelines for medical necessity review of speech therapy services. CMM-201:
More informationA Medical-Legal Review Regarding the Standard of Care for Epidural Injections, with Particular Reference to a Closed Case
Pain Physician 2010; 13:145-150 ISSN 1533-3159 Medical-Legal Review A Medical-Legal Review Regarding the Standard of Care for Epidural Injections, with Particular Reference to a Closed Case Standiford
More informationCLINICAL GUIDELINES. CMM-201 ~ Facet Joint Injections. Version 19.0 Effective August 11, 2017
CLINICAL GUIDELINES CMM-201 ~ Facet Joint Injections Version 19.0 Effective August 11, 2017 evicore healthcare Clinical Decision Support Tool Diagnostic Strategies:This tool addresses common symptoms and
More informationVijay Singh, M.D Roosevelt Rd., Niagara, WI 54151
Publications and Book Chapters Vijay Singh, M.D. 1601 Roosevelt Rd., Niagara, WI 54151 PUBLICATIONS Jul-Aug 2012 Jul-Aug 2012 Jul-Aug 2012 Jul-Aug 2012 Jul-Aug 2012 July 2012 July 2012 May-Jun 2012 May-Jun
More informationIs Dexamethasone Epidural Injection Effective in Relieving Radicular Pain in an Adult Population?
Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Physician Assistant Studies Student Scholarship Student Dissertations, Theses and Papers 2014 Is Dexamethasone Epidural Injection Effective
More informationCSNRBs are commonly performed under fluoroscopic
Published August 26, 2010 as 10.3174/ajnr.A2230 ORIGINAL RESEARCH T. Wolter S. Knoeller A. Berlis C. Hader CT-Guided Cervical Selective Nerve Root Block with a Dorsal Approach BACKGROUND AND PURPOSE: Cervical
More informationClinical Evaluation of Transforaminal Epidural Steroid Injection in Patients with Gadolinium Enhancing Spinal Nerves Associated with Disc Herniation
Pain Physician 2015; 18:E177-E185 ISSN 2150-1149 Observational Study Clinical Evaluation of Transforaminal Epidural Steroid Injection in Patients with Gadolinium Enhancing Spinal Nerves Associated with
More informationClinical Policy: Facet Joint Interventions
Clinical Policy: Reference Number: CP.MP.171 Last Review Date: 07/18 Coding Implications Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description
More informationClinical Policy: Intradiscal Electrothermal Therapy; Percutaneous Intradiscal Radiofrequency Thermocoagulation Reference Number: HNCA.CP.MP.
Clinical Policy: Intradiscal Electrothermal Therapy; Percutaneous Intradiscal Radiofrequency Thermocoagulation Reference Number: HNCA.CP.MP.48 Effective Date: 10/03 Last Review Date: 8/18 See Important
More informationLumbosacral Radicular Syndrome. Are interventions useful?
Lumbosacral Radicular Syndrome Are interventions useful? Koen Van Boxem, MD, PhD, FIPP Anesthesiology Multidisciplinary pain unit St-Jozefkliniek Bornem, Belgium Maastricht Universitair Medisch Centrum,
More informationClinical Policy Title: Spine pain epidural steroid injections
Clinical Policy Title: Spine pain epidural steroid injections Clinical Policy Number: 03.03.04 Effective Date: March 1, 2016 Initial Review Date: January 10, 2013 Most Recent Review Date: July 20, 2017
More informationEPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN
EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN Protocol: PAI001 Effective Date: April 1, 2018 Table of Contents Page COMMERCIAL & MEDICAID COVERAGE RATIONALE... 1 MEDICARE COVERAGE RATIONALE...
More informationMEDICAL POLICY STATEMENT INDIANA MEDICAID Original Issue Date Next Annual Review Effective Date 11/01/ /01/ /17/2017
MEDICAL POLICY STATEMENT INDIANA MEDICAID Original Issue Date Next Annual Review Effective Date 11/01/2017 11/01/2018 12/17/2017 Policy Name Policy Number Policy Type MEDICAL Administrative Pharmacy Reimbursement
More informationFACET JOINT INJECTIONS Version 18.0; Effective
evicore healthcare. Clinical Decision Support Tool Diagnostic Strategies This tool addresses common symptoms and symptom complexes. Imaging requests for patients with atypical symptoms or clinical presentations
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Friedly JL, Comstock BA, Turner JA, et al. A randomized trial
More informationEffective Date: 1/1/2019 Section: MED Policy No: 391 Medical Policy Committee Approved Date: 6/17; 12/18
Effective Date: 1/1/2019 Section: MED Policy No: 391 Medical Policy Committee Approved Date: 6/17; 12/18 1/1/2019 Medical Officer Date APPLIES TO: Medicare Only See Policy CPT/HCPCS CODE section below
More informationCigna Medical Coverage Policies Musculoskeletal Sacroiliac Joint Injections
Cigna Medical Coverage Policies Musculoskeletal Sacroiliac Joint Injections Effective January 25, 2017 Instructions for use The following coverage policy applies to health benefit plans administered by
More informationCigna Medical Coverage Policies Musculoskeletal Facet Joint Injections/Medial Branch Blocks
Cigna Medical Coverage Policies Musculoskeletal January 15, 2018 Instructions for use The following coverage policy applies to health benefit plans administered by Cigna. Coverage policies are intended
More informationA Novel Application of an Adjustable Catheter in Acute Radicular Pain Management
https://doi.org/10.1007/s40122-018-0110-0 BRIEF REPORT A Novel Application of an Adjustable Catheter in Acute Radicular Pain Management Maria Clemente. Carla Roero. Veronica Perlo. Elena Peila. Anna De
More informationSurvey of European Pain Medicine Practice
Pain Physician 2012; 15:E983-E994 ISSN 2150-1149 Survey Survey of European Pain Medicine Practice Sanjeeva Gupta, MD, FRCA, FFPMRCA 1, Manish Gupta, FRCA 2, Sherdil Nath, MD, FRCA 3, and G. Michael Hess,
More informationDecompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)
Last Review Status/Date: March 2017 Page: 1 of 9 Using Laser Energy (Laser Discectomy) or Description Laser energy (laser discectomy) and radiofrequency (RF) coblation (nucleoplasty) are being evaluated
More informationCigna Medical Coverage Policies Musculoskeletal Radiofrequency Joint Ablation/Denervation
Cigna Medical Coverage Policies Musculoskeletal Radiofrequency Joint Ablation/Denervation Effective January 1, 2016 Instructions for use The following coverage policy applies to health benefit plans administered
More informationSystematic Review of Effectiveness and Complications of Adhesiolysis in the Management of Chronic Spinal Pain: An Update
Pain Physician 2007; 10:129-146 ISSN 1533-3159 Review Systematic Review of Effectiveness and Complications of Adhesiolysis in the Management of Chronic Spinal Pain: An Update Andrea M. Trescot, MD 1, Pradeep
More informationPainful GP dilemmas Low Back Pain Leg Pain. Dr. Rajiv Chawla Consultant in Pain Medicine The Walton Centre Liverpool
Painful GP dilemmas Low Back Pain Leg Pain Dr. Rajiv Chawla Consultant in Pain Medicine The Walton Centre Liverpool Low back Pain Up to 80% of all adults will eventually experience back pain, and it is
More informationThe Comparison of the Result of Epiduroscopic Laser Neural Decompression between FBSS or Not
Original Article Korean J Pain 2014 January; Vol. 27, No. 1: 63-67 pissn 2005-9159 eissn 2093-0569 http://dx.doi.org/10.3344/kjp.2014.27.1.63 The Comparison of the Result of Epiduroscopic Laser Neural
More informationComments on Oregon Health Authority s Health Evidence Review Commission s Draft Coverage Guidance Corticosteroid Injections Low Back Pain
Comments on Oregon Health Authority s Health Evidence Review Commission s Draft Coverage Guidance Corticosteroid Injections Low Back Pain December 8, 2016 Representatives of the 11 undersigned medical
More informationZach Beresford, MD Essentia Health Duluth, MN
Zach Beresford, MD Essentia Health Duluth, MN Brief review of glucocorticoids and Epidural Steroids (ESI) Skeletal and non-skeletal effects of glucocorticoids Review of the evidence of skeletal effects
More informationEvaluation of Prognostic Predictors of Percutaneous Adhesiolysis Using a Racz Catheter for Post Lumbar Surgery Syndrome or Spinal Stenosis
Pain Physician 2013; 16:E531-E536 ISSN 2150-1149 Retrospective Evaluation Evaluation of Prognostic Predictors of Percutaneous Adhesiolysis Using a Racz Catheter for Post Lumbar Surgery Syndrome or Spinal
More informationLaxmaiah Manchikanti, MD, Kimberly A. Cash, RT, Vidyasagar Pampati, MSc, Bradley W. Wargo, DO, and Yogesh Malla, MD
Pain Physician 2010; 13:223-236 ISSN 1533-3159 Randomized Trial The Effectiveness of Fluoroscopic Cervical Interlaminar Epidural Injections in Managing Chronic Cervical Disc Herniation and Radiculitis:
More information