Strategies to Minimize Risk in Lumbar Transforaminal Injections: Imaging and Injectate

Myth #1: Neither the use of digital subtraction technology nor live fluoroscopy is needed during the performance of lumbar transforaminal epidural steroid injections.

Myth #2: Particulate steroids can be used as a first-line treatment in lumbar TFESIs.

Myth #3: A local anesthetic test dose does not affect the safety of lumbar TFESI.

Myth #4: The use of digital subtraction imaging during lumbar TFESI correctly identifies intra-arterial uptake and allows prevention of neurological events in all cases.

Learn about the facts surrounding these myths and the best practices to support safe performance of interventional pain procedures in your practice.

Each participant will read the FactFinder and will answer post-test questions to earn continuing medical education (CME) credits.

Adrian Popescu, MD; Zachary L. McCormick, MD; and Clark C. Smith, MD, MPH on behalf of the Spine Intervention Society‚Äôs Patient Safety Committee.

Materials presented in this activity have been made available by the Spine Intervention Society for educational purposes only. We reserve all rights to such material.

Educational Objectives
Upon completion of this activity, participants should be able to:

  • Identify best practices to ensure patient safety during interventional spine procedures 
  • Cite the evidentiary basis for risk mitigation strategies in the safe performance of interventional pain procedures.

Author Disclosures Information
Adrian Popescu, MD
Nothing to disclose

Zachary L. McCormick, MD
Nothing to disclose

Clark C. Smith, MD, MPH
Nothing to disclose

Adrian Popescu, MD
Nothing to disclose

Zachary L. McCormick, MD
Grant support: SIS, Foundation of PM&R, Midwest Pain Society
Travel expenses: SIS

Clark C. Smith, MD, MPH
Nothing to disclose

Accreditation Statement
The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
SIS designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Date of Activity Release: 
Date of Activity Expiration: 2/16/22

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