Mater Misericordiae University Hospital, Dublin, Republic of Ireland.
Mater Private Hospital, Dublin, Republic of Ireland.
Skeletal Radiol. 2021 Feb;50(2):343-349. doi: 10.1007/s00256-020-03565-y. Epub 2020 Jul 30.
To establish the incidence and define the nature of complications occurring following image-guided musculoskeletal injections at our institution.
All patients undergoing image-guided musculoskeletal injection during the study period (16/3/2016 to 24/01/2020) were included. Departmental records were reviewed to identify all patients describing possible complications following injection, what therapy was required (if any) and what the outcome was. No patients were excluded. Complications were classified as minor or major. Injections were categorised as follows: cervical spine, lumbar facet joint, lumbar nerve root, caudal epidural and 'other'. The complication rate for each individual category of procedure was compared with the combined complication rate for all other categories by constructing contingency tables and using Fisher's exact test.
A total of 8226 patients underwent image-guided musculoskeletal injections within the study period. Exactly 100 patients were identified as having reported a complication, producing an overall complication rate of 1.2%. One complication was categorised as 'major', with the patient requiring expedited surgery. The remainder (99 patients) were categorised as having experienced minor complications. The incidence of complications after 'other' injections was significantly greater than for other categories of injection (1.86%, p = 0.028). There was no significant difference in the complication rate for cervical spine (0.93%, p = 0.257), lumbar nerve root (0.85%, p = 0.401), lumbar facet joint (0.67%, p = 0.326) or caudal epidural (1.29%, p = 0.687) injections. 'Other' injections were subsequently further sub-categorised by anatomical site and imaging modality used. Glenohumeral (2.97%, p = 0.0361) and sacro-iliac (3.51%, p = 0.0498) joint injections were associated with a significantly increased risk of complications. There was no difference in the incidence of complications with fluoroscopic or ultrasound guidance.
In conclusion, image-guided musculoskeletal injections are safe and well-tolerated procedures. Complications are rare, occurring in just 1.2% of patients. 99% of complications are minor, either not requiring intervention or resolving with simple supportive treatment.
在我院建立影像引导下肌肉骨骼注射后并发症的发生率和定义其性质。
所有在研究期间（2016 年 3 月 16 日至 2020 年 1 月 24 日）接受影像引导下肌肉骨骼注射的患者均纳入本研究。通过查阅科室记录，确定所有患者描述了注射后可能出现的并发症、需要何种治疗（如有）以及结果如何。没有排除任何患者。并发症分为轻微或严重。注射分为以下几类：颈椎、腰椎小关节、腰椎神经根、骶管硬膜外和“其他”。通过构建列联表和使用 Fisher 精确检验，比较每个单独手术类别的并发症发生率与所有其他类别的合并并发症发生率。
在研究期间，共有 8226 名患者接受了影像引导下肌肉骨骼注射。共有 100 名患者被确定为报告了并发症，总并发症发生率为 1.2%。有 1 例并发症被归类为“严重”，患者需要紧急手术。其余 99 例患者被归类为轻微并发症。“其他”注射后的并发症发生率明显高于其他注射类别（1.86%，p=0.028）。颈椎（0.93%，p=0.257）、腰椎神经根（0.85%，p=0.401）、腰椎小关节（0.67%，p=0.326）或骶管硬膜外（1.29%，p=0.687）注射的并发症发生率无显著差异。随后，根据使用的解剖部位和成像方式对“其他”注射进一步进行了细分。肩盂肱关节（2.97%，p=0.0361）和骶髂关节（3.51%，p=0.0498）注射与并发症风险显著增加相关。透视或超声引导下并发症的发生率无差异。
总之，影像引导下肌肉骨骼注射是安全且耐受良好的操作。并发症罕见，仅发生在 1.2%的患者中。99%的并发症为轻微，无需干预或简单支持治疗即可缓解。
