Controversies in Spine Surgery; Epidural Spinal Injections; Dr. Nancy Epstein

SUMMARY: Dr. Nancy Epstein discusses the evidence proving that spinal epidural steroid injections have considerable short and long tern risks but no long term benefit.  She provides proof of nerve, spinal cord, cauda equina injuries, CSF leak, arachnoiditis, brain stem infarction, quadra or paraplegia and more. She reviews the anatomy and imaging to support those claims from a series of studies over the years. She analyses the studies over the past 10 years as evidence.  Have appropriate imaging studies been done before these injections are given? What are the alternatives?  Even though some insurance companies require these procedures, the patient is being exposed to unnecessary risks with these injections. Is it worth the risks to have your patient undergo this procedure? This is the evidence. You decide.  51 min. (JIA) 

Speaker
  • James I. Ausman, MD, MA, PhD

    CEO SNI and SNI Digital; Emeritus Professor Neurosurgery

  • Nancy Epstein, MD

    Chief, Neurosurgical Spine and Education, Winthrop Univesrity Hospital Mineola , New York, USA