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Epidural steroid injection (ESI) is a technique in which corticosteroids and a local anesthetic are injected into the epidural space around the spinal cord in an effort to improve spinal stenosis, spinal disc herniation, or both. It is of benefit with a rare rate of major side effects.
A large study of spinal stenosis from Finland found the prognostic factors for ability to work after surgery were ability to work before surgery, age under 50 years, and no prior back surgery. The very long-term outcome (mean follow-up time of 12.4 years) was excellent-to-good in 68% of patients (59% women and 73% men).
Thoracic spinal stenosis, at the level of the mid-back, is much less common. [13] In lumbar stenosis, the spinal nerve roots in the lower back are compressed which can lead to symptoms of sciatica (tingling, weakness, or numbness that radiates from the low back and into the buttocks and legs). [citation needed]
A spinal CSF leak can be caused by one or more meningeal diverticula or CSF-venous fistulas not associated with an epidural leak. [ 6 ] [ 7 ] [ 8 ] A spontaneous spinal cerebrospinal fluid leak may occur sometimes in those with predisposing heritable connective tissue disorders including Marfan syndrome and Ehlers–Danlos syndromes .
Cauda equina syndrome (CES) is a condition that occurs when the bundle of nerves below the end of the spinal cord known as the cauda equina is damaged. [2] Signs and symptoms include low back pain, pain that radiates down the leg, numbness around the anus, and loss of bowel or bladder control. [1]
The most common use of SCS is failed back surgery syndrome (FBSS) in the United States and peripheral ischemic pain in Europe. [4] [5]As of 2014 the FDA had approved SCS as a treatment for FBSS, chronic pain, complex regional pain syndrome, intractable angina, as well as visceral abdominal and perineal pain [1] and pain in the extremities from nerve damage.
Epidural administration: injection into the epidural space of the spinal cord.Epidural, (Greek): situated on or outside the dura mater, from epi- "on top of" + dura mater + -al. Adhesion (Latin) adhēsiōn- for Latin adhaesiōn- (stem of adhaesiō) a clinging, equivalent to adhaes(us), past participle of adhaerēre to adhere + -iōn- -ion.
The term "steroid dementia" was coined by Varney et al. (1984) in reference to the effects of long-term glucocorticoid use in 1,500 patients. [3] While the condition generally falls under the classification of Cushing's syndrome , the term "steroid dementia syndrome" is particularly useful because it recognizes both the cause of the syndrome ...