Complications

Periradicular therapy can lead to various complications, which must be differentiated into drug-induced complications and complications caused by the technique. Since a contrast medium must be applied to precisely localize the injection site, incompatibilities may occur. These manifest themselves as an allergic reaction and can range from reddening of the skin, nausea and dizziness to unconsciousness.

However, this complication occurs rather rarely. In addition, the medication applied contains cortisone, which has various side effects. These include increased reddening of the face, sweating, calf cramps, stomach problems, and an increase in blood sugar and blood pressure.

If these complications occur, they can be treated well with additional medication. Bleeding and infections can occur during the procedure itself, as germs can be carried into the wound from outside. If a hematoma forms in the area of the nerves or a massive infection spreads there, permanent paralysis and, depending on the injection site, paraplegia are possible.

However, this is a very rare complication. Furthermore, nerve injuries can occur when the performing physician hits a nerve with the needle. This can lead to massive pain and at times to paralysis in the leg.

Usually, however, these complications are reversible, as the needle can only slightly injure the nerve. Temporary signs of paralysis can also occur as a result of the application of the anesthetic and are relatively common. However, the paralysis disappears again when the anaesthetic is removed. If the anaesthetic is mistakenly injected directly into the dural sac, the paralysis can be much more pronounced and long-lasting, but even this paralysis is reversible. Should temporary paralysis occur after the therapy, the patient is no longer fit to drive.

Risks

Theoretically are possible. A certain time of monitoring after infiltration should be observed. Since periradicular therapy is an invasive procedure, some risks are possible.

For this reason, the patient must be informed about the existing risks and give a written declaration of consent. As periradicular therapy is an invasive procedure, infections and bleeding are always possible. However, these risks can be minimized by sterile work and the minimally invasive procedure.

Nevertheless, these complications do occur in some cases. If a hematoma forms or an infection spreads in the area of the nerve root, paralysis is possible. In most cases these are reversible, but in exceptional cases the paralysis persists.

In addition, other structures such as nerves or ligaments and muscles in the area of the injection site may be injured while the needle is being positioned. However, due to the CT-guided procedure and thus a constant control of the position, these risks are very low. During the examination, the patient is administered a contrast medium via the vein to visualize the structures.In some cases, this causes allergic reactions, which can manifest themselves in the form of dizziness, itching, redness or even an allergic shock.

Furthermore, the patient is injected with various drugs in the area of the nerve root. These drugs contain, among other things, cortisone, which has an anti-inflammatory effect. However Kortison can take influence on the blood sugar and the blood pressure.

For this reason diabetics or patients with a blood high pressure are rather endangered to be affected by these risks. In many cases, the injection of the local anesthetic causes a temporary weakness of the affected muscles. For this reason, the patient is not fit to drive within the first 6 hours after the therapy.

If the medication is injected too deeply by mistake and thus into the dural sac, stronger and longer lasting paralysis is possible. However, even these paralysis symptoms are usually fully reversible after absorption of the drug. Depending on the place of injection, in the worst case the drug can cause respiratory paralysis if injected too deeply.

Injuries of the nerve root
Bleeding
Bacterial inflammation
Allergic reaction to the medication

The side effects of periradicular therapy include, first of all, the not inconsiderable radiation exposure, especially in the lumbar region, and the resulting risk. Furthermore, the injections themselves can cause some complications. First of all, there is always the risk of an allergic reaction to the medication used or the contrast medium.

Also, the cortisone used, especially when used more frequently, can lead to side effects such as the fragility of small vessels, an increase in blood sugar or cycle disorders in women. The puncture itself carries the risk of damage to nerves or spinal cord. The invasive penetration can also lead to bleeding or infection.

However, this is very rare due to X-ray control. After the treatment, there may be temporary sensory disturbances in the legs, as well as burning and pain at the puncture site. If the anesthetic enters the spinal canal, temporary paralysis of the legs may also occur. Nausea, headache, dizziness and high blood pressure are also possible immediately after the treatment. However, these usually occur directly after the treatment, i.e. still under medical supervision, and usually improve quickly.