Some side effects associated with spinal puncture include bruising, bleeding, infections, headaches, and blood clots. Cortisone side effects may cause weight gain, water retention, hot flashes, mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Epidural steroid injections can provide diagnostic and therapeutic benefits. ESIs have been endorsed by the North American Spine Society and the Agency for Healthcare Research and Quality of the Department of Health and Human Services. Discuss this procedure with your friendly and caring doctor at the Florida Spine Institute to determine whether it is the right treatment for you.
An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. Traditionally epidural injections were administered without any special equipment, by inserting the needle by feel in the area around the spinal nerves. More recently epidural injections have been administered with the aid of imaging tools to allow your physician to see the needle going to the proper location. Either real-time x-ray, called fluoroscopy, or CT scan can be used to 'watch' the needle deliver the medication to the proper location.
These case reports indicate fluoroscopic guidance will not insure or prevent intrathecal perforation or spinal cord penetration during the administration of cervical epidural steroid injections. In addition, although intravenous sedations during cervical epidural steroid injections have been used numerous times without reported complications, it appears intravenous sedation in these two cases resulted in the inability of the patient to experience the expected pain and paresthesias at the time of spinal cord irritation. Therefore, the authors conclude that the patient should be fully awake during the administration of cervical epidural steroid injections, with only local anesthetic in the skin used for analgesia.