Safety and Risk Mitigation for Cervical Transforaminal Epidural Steroid Injections

Purpose of Review: The purpose of this study is to describe the most common complications of cervical transforaminal epidural steroid injection and to differentiate these from rare but serious risks unique to cervical transforaminal epidural steroid injections (CTFESI). Relevant safety mitigation techniques will also be discussed. Recent Findings: The largest available cohort of epidural steroid injections was recently published, without a single case of major neurologic damage captured. Summary: A large body of evidence suggests that the risk of neurologic infarct following CTFESI is due to the embolic effect of inadvertent arterial injection of particulate steroids. The advent of safety techniques to mitigate this risk, namely restricting use of steroids to the non-particulate steroid dexamethasone, seems to have greatly improved the safety profile of CTFESI.