Question:I have diabetes and brittle bones. After a bad accident I also have a herniated disc in my neck. The doctors don't want to do surgery. They've suggested an epidural steroid injection instead. What are the risks of this operation?
Epidural steroid injection (ESI) is a way to inject anti-inflammatory drugs into the space surrounding the spinal cord. This helps with pain relief and swelling in the area from the local tissue damage.
Diabetes is a strong risk factor for blood infections that cause abscess formation in the epidural space. Poorly controlled diabetes can lead to a variety of blood vessel and tissue changes. Without a good blood supply even small wounds heal slowly or not at all. Any small break in the skin or tissue underneath can lead to infection.
Once bacteria enter the open break, they multiply rapidly. The extra glucose in the body fluids and tissues feeds the bacteria. Patients with diabetes are at risk for any kind of infection (skin, urinary, blood).
Abscess formation doesn't occur very often after ESI. When it does, pressure on the spinal cord in the neck region (or spinal nerves in the lumbar spine) can cause nerve damage. The patient may have extreme pain, numbness, and muscle weakness.Russel C. Huang, MD, et al. Cervical Epidural Abscess after Epidural Steroid Injection. In Spine. January 1, 2004. Vol. 29. No. 1. Pp. E7-E9.
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