Safety Considerations for Spinal Injections

UCSF Radiologist Dr. Dillon goes over a list of important issues to keep in mind when performing a spinal injection. He also shares a couple non-UCSF cases where these considerations were ignored.
 

Selective Nerve Root Block Complications

  • Embolization of Artery Adamkiewicz
    • 85% of individuals arises between T9 and L2
    • May arise from the lower lumbar spine and rarely from S1
    • 6 reports of paraplegia from lumbar injections (L3-4 and S1)
    • Particulate mixture higher risk
      • Decadron-no particulates, safer in thoracic and cervical
  • Vertebral artery injection
    • Cervical injections under fluoro are higher risk

We recommend CT guidance for cervical root blocks

Faculty

Professor
Interim Chair, Department of Radiology & Biomedical Imaging
Executive Vice-Chair
Professor & Interim Chair

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