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When epidural steroids are injected into the spine, they can potentially cause life-threatening complications, including blindness, stroke, paralysis, and death. Although rare, experts have been warning about this danger for the last decade.

FDA Safety Warning for Epidural Steroid Injections

April 23, 2014 — The U.S. Food and Drug Administration (FDA) has issued a Drug Safety Communication to warn:

“Injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death.”

The FDA has received reports of neurological adverse events associated with epidural steroid injections, including death, spinal cord infarction, paraplegia, quadriplegia, cortical blindness, stroke, seizures, nerve injury, and brain edema. Many patients did not recover.

What Should I Do?

Seek emergency medical attention immediately for any unusual symptoms after receiving an epidural steroid injection, such as:

  • loss of vision or vision changes
  • tingling in your arms or legs
  • sudden weakness or numbness of your face, arm, or leg on one or both sides of the body
  • dizziness
  • severe headache
  • seizures

What is an Epidural Steroid?

Epidural corticosteroid injections are given to treat neck and back pain, radiating pain in the arms or legs, and reduce swelling or inflammation. The practice of injecting steroids into the spine has been widespread for decades, but the FDA has never approved corticosteroids for this use, and the safety and effectiveness have never been evaluated.

Types of injectable corticosteroids include:

  • methylprednisolone
  • hydrocortisone
  • triamcinolone
  • betamethasone
  • dexamethasone

Spinal Cord Infarction Following Epidural Steroid Injection

Over the last decade, numerous studies have raised concern about neurological problems and other complications of spinal epidural injections. These studies describe the problem as a spinal cord infarction, which is a stroke that occurs in the spinal cord or the artery that supplies it with blood.

Symptoms of spinal cord infarction:

  • Intermittent sharp or burning back pain
  • Aching pain down through the legs
  • Weakness in the legs
  • Paralysis
  • Loss of deep tendon reflexes
  • Loss of pain and temperature sensation
  • Incontinence

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