Safety of CT-Guided Lumbar Nerve Root Infiltrations

Abstract

Selective nerve root infiltrations are frequently performed in patients with lumbar radiculopathy. Computed tomography (CT) is now commonly used for image guidance. Despite the widespread use of CT-guided lumbar nerve root infiltrations few studies have systematically examined the safety of this approach. In a two-year period, 231 lumbar nerve root infiltrations were performed on in-patients and were retrospectively reviewed. No major complications like inflammation (especially spondylodiscitis), large haematomas requiring surgery, severe allergic reactions or spinal ischaemia occurred. In accordance with other published studies, CT-guided lumbar nerve root infiltrations seem to be safe. To minimize the risk of catastrophic neurological complications due to spinal ischaemia, careful needle placement dorsal to the nerve root and the use of a non-particulate corticosteroid, like dexamethasone, are advocated.