The safety of CT-guided epidural steroid injections in an older patient cohort

Background: epidural steroid injections (esis) are a common method for treating lower back pain,which is one of the most prevalent health-related complaints in the adult u.s. population. although the safety of ct-guided esis has been extensively studied in adults,there is limited data concerning the procedure’s safety profile in an older patient population. objective: this retrospective study analyzed safety data among a single-center cohort of patients > 65 years-old who received one or more ct-guided interlaminar esis from 2012 to 2015. study design: an institutional review board (irb)-approved retrospective chart review. setting: university hospital center. methods: a total of 688 ct-guided esi procedures were evaluated and a linear regression analysis was conducted to examine the relationship between dose length product (dlp),body mass index (bmi),procedure duration,and kvp/ma settings. further analysis was performed on a sample of long procedure time,average-dlp and high-dlp procedures. results: average age was 75.77 years,with 44% having a bmi > 30. the mean dlp was 55.58 mgy x cm and the mean procedure duration was 5.94 minutes. all procedures were technically successful and no complications were observed during or after any of the procedures,including at one-month follow-up office visits. the kvp and ma settings were the strongest predictors of dlp,followed by procedure time. the high-dlp cases had a greater number of needle placement series,more intervertebral disc spaces included in each planning series and higher machine settings (kvp 120; ma 87.5) than the average-dlp cases (kvp 100; ma 49.9). limitations: this study is limited by its retrospective design. conclusion: ct-guided interlaminar esis can be performed safely,with low procedure times,relatively low dlp’s and without complications in an older patient population. © 2016,american society of interventional pain physicians. all rights reserved.