Category Archives: Epidural steroid injection

Patients over 70 do well after minimally invasive spinal stenosis surgery

Rosemary Frei writing in Pain Management News reported on a study led by Raja Rampersand, MD at the Spinal Program of the Toronto Western Hospital and the University of Toronto. Analysis of data from 2008 to 2011 compared patients aged 40 to 69 with patients past the age of 70 who underwent surgical decompression for lumbar spinal stenosis.  There were no differences in adverse events between the two groups, although patients in both groups took longer to recover if a fusion accompanied the decompression. lumbar-spinal-stenosis-old-man

Comment: Spinal stenosis is one of the most common low back syndromes seen in rheumatology practice.  Although epidural steroid injections and physical therapy can be effective for many patients, many people with this malady go on to have surgery. This study provides encouraging news for patients with spinal stenosis.

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Epidural steroid injections for arthritis… another risk

One of the most common problems seen in clinical rheumatology practice is low back pain related to osteoarthritis.  Many of us rheumatologists do epidural injections for patients with spinal arthritis, particularly when patients have spinal stenosis.

As you can imagine there has been a furor over recent reported of fungal, meningitis related to tainted steroid preparations.  The New York Times reported “that more people may be at risk from contaminated drugs” produced by the “company linked to a growing meningitis outbreak.” The FDA also said that products from the New England Compounding Center in Framingham, Massachusetts, “may have also caused other types of infections in patients who have had eye operations or open-heart surgery.”

Fortunately, our practice does not use a compounding pharmacy as a source for injectable steroids.

This is a terrible occurrence, and is one that should remind us all about the risks of medical therapies.

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