Perspectives

Spinal Injections: Trends in the US Outpatient Population

Authors: Douglas D. Dean, DO, M. Brigid Maruszak, DO, Laura F. Sandoval, DO

Abstract

Chronic low back pain is one of the most common complaints addressed by primary care physicians. When conservative approaches fail, minimally invasive interventional procedures such as epidural steroid injections are often used. These injections are generally well tolerated; however, serious adverse effects can occur. The outbreak of fungal meningitis in 2012 linked to contaminated methylprednisolone acetate vials distributed by the New England Compounding Center used for epidural injections highlights serious potential complications.1

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References

1. Centers for Disease Control and Prevention. Multistate outbreak of fungal meningitis and other infections. http://www.cdc.gov/hai/outbreaks/meningitis.html. Accessed August 28, 2013.
 
2. Manchikanti L, Pampati V, Falco FJ, et al. Assessment of the growth of epidural injections in the medicare population from 2000 to 2011. Pain Physician 2013;16:E349-E364.
 
3. Friedly J, Chan L, Deyo R. Increases in lumbosacral injections in the Medicare population: 1994 to 2001. Spine 2007;32:1754-1760.
 
4. National Center for Health Statistics. National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm. Accessed June 20, 2014.
 
5. Choi HJ, Hahn S, Kim CH, et al. Epidural steroid injection therapy for low back pain: a meta-analysis. Int J Technol Assess Health Care 2013;29:244-253.