=====Lumbar Epidural Steroid Injection Complication=====
[[Lumbar Epidural Steroid Injection]] Complication

Certified Registered Nurse Anesthetists (CRNAs) were able to safely and effectively perform fluoroscopic guided LESIs with complication rates similar to physician rates cited in the literature. Additional study of definitions of complications and CRNA complication rates for other pain management procedures is recommended
((Beissel DE. Complication Rates for Fluoroscopic Guided Interlaminar Lumbar
Epidural Steroid Injections Performed by Certified Registered Nurse Anesthetists 
in Diverse Practice Settings. J Healthc Qual. 2015 Jul 1. [Epub ahead of print]
PubMed PMID: 25627701.
))


====Case reports====
===2015===


Anwari et al report a patient who developed headache 5 days after a lumbar epidural steroid injection, which was not related to the epidural procedure, but caused by Duloxetine induced hyponatremia. Antidepressant drug induced headache should be considered in the differential diagnosis of post dural puncture headache
((Anwari JS, Hazazi AA. Another cause of headache after epidural injection.
Neurosciences (Riyadh). 2015 Apr;20(2):167-9. doi: 10.17712/nsj.2015.2.20140769. 
PubMed PMID: 25864071.
)).
----
A case of cervical meningomyelitis followed by multiple lumbar ESI. A 60-year-old male with diabetes mellitus presented to the hospital with severe neck pain. He had a history of multiple lumbar injections from a local pain clinic. After admission, high fever and elevated inflammatory values were detected. L-spine magnetic resonance imaging (MRI) revealed hematoma in the S1 epidural space. Antibiotic treatment began under the diagnosis of a lumbar epidural abscess. Despite the treatment, he started to complain of weakness in both lower extremities. Three days later, the weakness progressed to both upper extremities. C-spine MRI revealed cervical leptomeningeal enhancement in the medulla oblongata and cervical spinal cord. Removal of the epidural abscess was performed, but there was no neurological improvement
((Lee Y, Kim JS, Kim JY. Cervical Meningomyelitis After Lumbar Epidural Steroid 
Injection. Ann Rehabil Med. 2015 Jun;39(3):504-7. doi: 10.5535/arm.2015.39.3.504.
Epub 2015 Jun 30. PubMed PMID: 26161360; PubMed Central PMCID: PMC4496525.
)).

===2014===
Spinal cord ischemia is a rare but possible neurological complication following routine conservative treatment of lumbosacral radiculopathy. A case of a 46 year old woman with chronic L5 radiculopathy, who developed spinal cord ischemia following epidural steroid injection, is reported. Two months after the epidural injection, she required crutches for walking and had neurogenic bladder and bowel
((AbdeleRahman KT, Rakocevic G. Paraplegia following lumbosacral steroid
epidural injections. J Clin Anesth. 2014 Sep;26(6):497-9. doi:
10.1016/j.jclinane.2014.03.010. Epub 2014 Sep 4. PubMed PMID: 25200706.
)).