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Anesthetic Test Dose and Seizure Risk with Cervical Transforaminal Epidural Steroid Injection

S neurological complications from cervical transforaminal injection of steroids (CTFIS) have been attributed to inadvertent injection of particulate steroids into a radicular artery or a vertebral artery [1-5]. The complications include spinal cord infarction, brainstem infarction, cerebral infarction, and death [3]. Two measures have been advocated to prevent these complications. One is to use a test-dose of local anesthetic, and the other is to use non-particulate steroids.