ABSTRACT
Epidural depot steroids relieve radicular pain caused by nerve root pathology, but not unspecific “low back pain.” Transforaminal epidural injection of steroid is more effective, but also carries higher risk of major, irreversible complications than interlaminar or caudal epidural injection. Epidural steroid injections are generally safe in the hands of well-trained, experienced physicians, with experience in resuscitation routines, with adequate fluoroscopic equipment, and understanding of anatomic details and risk factors. Epidural steroids have not been related to arachnoiditis. Reviewing the evidence for epidural steroid injections, there are studies claiming success rates ranging from no better than placebo to 90 percent benefit. Transforaminal steroid injections performed with fluoroscopy and local anesthetic injection to prevent intra-arterial injections are generally safe. Systemic infection or local infection at the site of the injection. There have been reports of tuberculosis being reactivated by epidural steroid injections.
