LESI LESI Complications and Risks

Question 1

Which is the most feared catastrophic complication of transforaminal lumbar ESI?

Accepted Answer

Spinal cord infarction causing paraplegia

Answer

Spinal cord infarction due to inadvertent intra-arterial injection of particulate steroid into a radiculomedullary artery is the most feared catastrophic complication of transforaminal LESI.

Question 2

Postdural puncture headache (PDPH) after ESI is caused by:

Accepted Answer

Inadvertent dural puncture causing CSF leak

Answer

PDPH results from inadvertent dural puncture with subsequent CSF leak, lowering intracranial pressure and causing the characteristic postural headache.

Question 3

What is the characteristic feature of postdural puncture headache that distinguishes it from other headaches?

Accepted Answer

Positional — worse when upright, relieved when supine

Answer

PDPH is characteristically positional — it worsens significantly when the patient sits or stands and improves within minutes of lying flat due to changes in CSF pressure.

Question 4

An epidural abscess following LESI most commonly presents with which triad of symptoms?

Accepted Answer

Back pain, fever, and neurological deficits

Answer

Epidural abscess classically presents with the triad of back pain, fever, and progressive neurological deficits, and represents a surgical emergency requiring prompt diagnosis.

Question 5

Intrathecal injection during an intended epidural injection can cause which life-threatening complication?

Accepted Answer

Total spinal anesthesia with respiratory arrest

Answer

Intrathecal injection of the full epidural dose can cause total spinal anesthesia with high motor block, respiratory paralysis, and cardiovascular collapse requiring emergency resuscitation.

LESI - Lumbar Epidural Steroid Injection Practice Test

LESI - Lumbar Epidural Steroid Injection Practice Test

LESI LESI Complications and Risks