Assessment of the frequency and structure of complications during lumbar epidural injections in the practice of an outpatient pain management center

Introduction. Lumbar epidural injections are widely used for chronic low back pain and radicular pain.

The aim. To assess the frequency and structure of transient procedure-related reactions, systemic adverse drug reactions, and procedure-related complications associated with lumbar epidural injections in an outpatient pain management center.

Materials and methods. A single-center retrospective observational study was conducted from January 2016 to January 2026. The study group included patients who underwent fluoroscopy-guided interlaminar and transforaminal lumbar epidural injections. A total of 3,757 procedures were analyzed.

Results. Eighty-five events were recorded (2.26 % of all procedures): 5 procedure-related complications (0.133 %), including 3 cases of post-dural puncture headache and 2 cases of pneumocephalus; 39 transient procedure-related reactions (1.04 %); and 41 systemic adverse drug reactions (1.09 %). Most events were transient and reversible. Two cases of pneumocephalus after interlaminar injections required hospitalization and resolved completely.

Conclusion. Lumbar epidural injections performed under fluoroscopic guidance and in accordance with safety standards are associated with a low rate of clinically significant procedure-related complications. Separate reporting of the three event categories provides a more accurate assessment of procedural safety.

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