LESI LESI Patient Selection and Contraindications

Question 1

Which condition is an ABSOLUTE contraindication to lumbar ESI?

Accepted Answer

Active systemic infection or local infection at the injection site

Answer

Poorly controlled diabetes

Answer

Mild coagulopathy (INR 1.2)

Answer

Patient age over 80 years

Question 2

According to ASRA guidelines, what INR threshold generally requires postponement of ESI?

Accepted Answer

INR > 1.5

Answer

INR > 1.2

Answer

INR > 2.0

Answer

INR > 3.0

Question 3

LESI is generally most effective for which type of pain generator?

Accepted Answer

Radicular pain from nerve root compression or inflammation

Answer

Axial low back pain from facet arthropathy

Answer

Sacroiliac joint pain

Answer

Myofascial pain syndrome

Question 4

Which patient population requires special caution with ESI due to increased susceptibility to steroid-related complications?

Accepted Answer

Immunocompromised patients and those with poorly controlled diabetes

Answer

Athletes in competitive sports

Answer

Patients under 40 years of age

Answer

Patients with mild hypertension

Question 5

A patient on warfarin for atrial fibrillation needs ESI. How long should warfarin typically be held before the procedure?

Accepted Answer

4-5 days

Answer

12 hours

Answer

24 hours

Answer

7-10 days

Question 6

Which patient history indicates that an ESI may be futile or contraindicated due to prior surgical disruption of the epidural space?

Accepted Answer

Prior lumbar fusion at the target level with hardware

Answer

Prior physical therapy at the same spinal level

Answer

Prior lumbar ESI at the same level 6 months ago

Answer

Prior steroid injection at a different spinal level