Complications of cervical epidural nerve blocks with steroids

As noted earlier, the advent of Pap smear screening for cervical cancer has halved the death rate from the disease since 1980. Make sure to follow the guidelines for screening, but keep in mind that these are general guidelines designed for the population as a whole. There may be reasons to have screening (or to not screen) for you as an individual that are not covered under these recommendations. It's also important to note that screening tests are meant for people who are asymptomatic—who have no symptoms of a disease. If you have any of the symptoms listed earlier, further tests may be considered beyond a screening Pap smear. If you are unsure if you need these tests, check out these guidelines for cervical cancer screening .

Smoking
The most important thing you can do to ensure the success of your spinal surgery is quit smoking. This includes cigarettes, cigars, pipes, chewing tobacco, and smokeless tobacco (snuff, dip). Nicotine prevents bone growth and puts you at higher risk for a failed fusion. Patients who smoked had failed fusions in up to 40% of cases, compared to only 8% among non-smokers [1]. Smoking also decreases your blood circulation, resulting in slower wound healing and an increased risk of infection. Talk with your doctor about ways to help you quit smoking: nicotine replacements, pills without nicotine (Wellbutrin, Chantix), and tobacco counseling programs.

Huntoon 13 investigated cervical blood flow in a cadaveric study and noted that the ascending and deep cervical arterial branches may contribute significantly to the anterior segmental arteries. Consequently, the anterior spinal artery flow may be susceptible to injury during interventional procedures. Steroids for spinal interventional procedures are not created equal because homogenicity and potency are variable. Derby et al 18 investigated particle size and aggregation frequency of commonly used spinal corticosteroids ( Table 14-1 ). The larger the particle size and the higher the aggregation, the more likely ischemic injury can result from embolic phenomena.

Complications of cervical epidural nerve blocks with steroids

complications of cervical epidural nerve blocks with steroids

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