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6. Hidden risk of gadolinium-based contrast agents during interventional pain medicine procedures: a retrospective chart review.

Author

Hallo-Carrasco, Alejandro, Eldrige, Jason, Provenzano, David Anthony, Gonzalez-Estrada, Alexei, Abdel-Latif, Tesneem, Klasova, Johana, Furtado-Pessoa-de-Mendonca, Laura, Yan, Dan, and Hunt, Christine

Abstract

Introduction: Epidural steroid injections and epidural blood patches commonly involve the injection of a small amount of radiocontrast media under fluoroscopy to properly identify the target tissue or anatomic space and prevent off-target or intravascular delivery of therapeutic or diagnostic drugs. Iodinated low osmolar non-ionic contrast media is the standard preparation used as it is considered safe and cost-effective, but gadolinium-based preparations have been used as an alternative for patients with an 'iodine'-related or radiocontrast media allergy label to prevent hypersensitivity reactions. The risk of neurotoxic events when gadolinium is inadvertently injected into the intrathecal space has been reported in recent years, raising concerns when gadolinium-based contrast media is used in lieu of iodinated low osmolar non-ionic contrast media. Methods: A retrospective review was conducted of patients who received gadolinium-based contrast media for procedures with risk of inadvertent intrathecal access from January 1, 2019 to May 1, 2022. Information on patient demographics, allergy label information, and procedure description was documented for all patients who received gadolinium-based contrast media for axial spine procedures (including epidural steroid injections, epidural blood patch procedures, and selective nerve root blocks), and all side effects reported within 1 month of the procedure were recorded. Saved fluoroscopy images of all procedures for which there was concern for possible gadolinium-based contrast media-related side effect were reviewed for evidence of inadvertent intrathecal gadolinium-based contrast media administration. Descriptive statistical analysis was performed using REDCap and IBM SPSS Statistics V.28. Results: We identified 508 patients who received gadolinium-based contrast media during a fluoroscopically guided axial spine procedure. These patients underwent 697 epidural procedures and 23 patients were identified as experiencing an adverse event that could be consistent with possible, probable, or clear signs of exposure to intrathecal gadolinium. Our calculated adverse event rate was 3.3%. Ten patients required additional medical evaluation or treatment. Discussion: Almost all patients in our cohort had an allergy label on their chart that guided the provider to switch to gadolinium-based contrast media, but most were incomplete, ill-defined, or related to allergy to iodine but not iodinated contrast media. Such practice is not recommended based on current guidelines. The current study raises concern regarding the use of gadolinium-based contrast media in axial spine procedures, with the risk of potential severe adverse events, without evidence-based need for avoiding iodinated contrast media. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Spinal Cord Stimulator Implant Infection Rates and Risk Factors: A Multicenter Retrospective Study

Author

Hoelzer, Bryan C., Bendel, Mark A., Deer, Timothy R., Eldrige, Jason S., Walega, David R., Wang, Zhen, Costandi, Shrif, Azer, Gerges, Qu, Wenchun, Falowski, Steven M., Neuman, Stephanie A., Moeschler, Susan M., Wassef, Catherine, Kim, Christopher, Niazi, Tariq, Saifullah, Taher, Yee, Brian, Kim, Chong, Oryhan, Christine L., Rosenow, Joshua M., Warren, Daniel T., Lerman, Imanuel, Mora, Ruben, Hayek, Salim M., Hanes, Michael, Simopoulos, Thomas, Sharma, Sanjiv, Gilligan, Chris, Grace, Warren, Ade, Timothy, Mekhail, Nagy A., Hunter, John P., Choi, Daniel, and Choi, Deborah Y.

Published
2017
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11. Spinal Cord Stimulator Related Infections: Findings From a Multicenter Retrospective Analysis of 2737 Implants

Author

Bendel, Markus A., O’Brien, Travis, Hoelzer, Bryan C., Deer, Timothy R., Pittelkow, Thomas P., Costandi, Shrif, Walega, David R., Azer, Gerges, Hayek, Salim M., Wang, Zhen, Eldrige, Jason S., Qu, Wenchun, Rosenow, Joshua M., Falowski, Steven M., Neuman, Stephanie A., Moeschler, Susan M., Wassef, Catherine, Kim, Christopher, Niazi, Tariq, Saifullah, Taher, Yee, Brian, Kim, Chong, Oryhan, Christine L., Warren, Daniel T., Lerman, Imanuel, Mora, Ruben, Hanes, Michael, Simopoulos, Thomas, Sharma, Sanjiv, Gilligan, Chris, Grace, Warren, Ade, Timothy, Mekhail, Nagy A., Hunter, John P., Choi, Daniel, and Choi, Deborah Y.

Published
2017
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20. Pain Associated With Monkeypox Virus: A Rapid Review

Author

Hallo-Carrasco, Alejandro, primary, Hunt, Christine L, additional, Prusinski, Christian C, additional, Eldrige, Jason S, additional, McVeigh, Kimberly H, additional, Hurdle, Mark Friedrich B, additional, Prokop, Larry J, additional, and Gupta, Sahil, additional

Published
2023
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22. Reddit Users’ Perspectives of Spinal Cord Stimulation: An Analysis of Data Source from Reddit

Author

Hallo-Carrasco, Alejandro, Eldrige, Jason, Hurdle, Mark, Provenzano, David, and Hunt, Christine

Subjects
Medicine and Health Sciences
Abstract

Chronic pain affects 20% of adults worldwide. Broad access to online resources has encouraged people to organize online and share experiences and provide support to others who understand the struggles of living with chronic pain.[1, 2] In the past decade, 72% of internet users have searched for health-related information online, and up to 35% have searched for self-diagnosis. This behavior is common among people with chronic conditions who seek emotional and experiential support online.[3] Patients frequently search for treatment options or experiences from people that underwent a procedure offered by their providers. Spinal cord stimulation is a nonpharmacological treatment option for neuropathic appendicular or axial pain not treatable by surgery and refractory to conservative medical management and has been the subject of online discussions.[4] The social media platform Reddit is one of the most frequently visited websites in the United States where online communities have organized and discussed a myriad of topics under pseudonymous usernames.[3] Reddit users have a semi-unrestricted space to submit posts, comments, and reply to other opinions. Moreover, the anonymity of users distinguishes the platform from other social media platforms and allows users to discuss sensitive information and personal struggles without the risk of social stigma or offline harm. [3, 5] This combination of qualities made Reddit a popular social media platform for health-related inquiries and an attractive option for researchers to explore opinions and common questions about treatment options.[6] To our knowledge, no work has been done to evaluate patients' opinions and questions about spinal cord stimulation using data obtained from this social media platform. Understanding what patients may read in this online forum is of benefit to physicians in anticipating what questions patients may have, and what information is important to provide to patients to help clarify risks, expectations, and education about SCS therapy.

Published
2022
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26. A scoping review of psychiatric barriers to spinal cord stimulation implantation and their management

Author

Fisher, Kristy, Hunt, Christine, Prokop, Larry, Rosado, Robert, and Eldrige, Jason

Subjects
Rehabilitation and Therapy, Medical Sciences, nervous system, integumentary system, Medical Education, Mental and Social Health, Other Mental and Social Health, Interprofessional Education, Medicine and Health Sciences, Psychiatric and Mental Health, Analytical, Diagnostic and Therapeutic Techniques and Equipment, tissues, Other Rehabilitation and Therapy
Abstract

The authors aim to conduct a scoping review to identify assessments utilized to identify patients with pronounced psychiatric symptom burden that may complicate optimal response to SCS therapy despite passing a psychiatric evaluation; clearly define accepted strict psychiatric contraindications to SCS implantation; and review how psychiatric comorbidities may be addressed or managed to improve a patient’s candidacy for SCS treatment in patients who do not pose strict contraindications to proceeding with SCS implant but may be at risk for suboptimal long-term response.

Published
2022
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41. Ultrasound-guided transversus abdominis plane block vs trigger point injections for chronic abdominal wall pain: a randomized clinical trial

Author

Moeschler, Susan M., primary, Pollard, E. Morgan, additional, Pingree, Matthew J., additional, Pittelkow, Thomas P., additional, Bendel, Mark A., additional, Mauck, W. David, additional, Watson, James C., additional, Eldrige, Jason S., additional, Loftus, Conor G., additional, and Hooten, W. Michael, additional

Published
2021
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43. A three-dimensional computed tomography study to determine the ideal method for fluoroscopically-guided bone marrow aspiration from the iliac crest

Author

D'Souza, Ryan S., primary, Li, Langping, additional, Leng, Shuai, additional, Hunt, Christine, additional, Law, Luke, additional, Muir, Casey, additional, Eldrige, Jason, additional, Bydon, Mohamad, additional, Chi, Meng, additional, Shapiro, Shane, additional, Mauck, William D., additional, and Qu, Wenchun, additional

Published
2020
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49. Nonsurgical integrative inpatient treatments for symptomatic lumbar spinal stenosis: a multi-arm randomized controlled pilot trial

Author

Kim, Kiok, primary, Shin, Kyung-Min, additional, Hunt, Christy L., additional, Wang, Zhen, additional, Bauer, Brent A., additional, Kwon, Ojin, additional, Lee, Jun-Hwan, additional, Seo, Bok-Nam, additional, Jung, So-Young, additional, Youn, Yousuk, additional, Lee, Sang Ho, additional, Choi, Jung Chul, additional, Jung, Jae Eun, additional, Kim, Jaehong, additional, Qu, Wenchun, additional, Kim, Tae-Hun, additional, and Eldrige, Jason S., additional

Published
2019
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