Percutaneous Treatment of Vertebral Bone Cyst
Alexander R. Vaccaro, Christopher M. Bono in Minimally Invasive Spine Surgery, 2007
It is generally recommended that sclerotherapy be performed utilizing general anesthesia in the operating room or in the angiography suite. The technique for injection involves direct puncture of the cyst under CT or fluoroscopic guidance using a 14- to 18-gauge needle. Blood return should be noted and fluid may then be aspirated. Contrast medium is then injected into the lesion to demonstrate filling of the cyst. The volume of contrast material should be noted. If complete filling of the cyst does not occur, additional injection sites may be required. Incomplete filling may be the result of septations within the lesion. The venous drainage of the contrast material should also be assessed. It should be minimal. Without the ability to compress the venous drainage system, areas with marked venous drainage should not be injected, as this can risk embolization of the venous system (10). In areas around vital structures, histoacryl may be the sclerosing agent of choice. An amount equal to the injected contrast material needed to fully opacify the cyst should be utilized. This should be injected slowly with minimal pressure (11). Alternatively, injection with methylprednisolone acetate (80 to 125 mg) in conjunction with calcitonin (100 to 200 IU) may also be used (7,8).
Immunotherapy of Graves’ Eye Disease
George S. Eisenbarth in Immunotherapy of Diabetes and Selected Autoimmune Diseases, 2019
Garber26 treated 15 patients with 10 to 15 mg methylprednisolone acetate between 2 and 18 times, over a period of 2 to 24 months. There were moderate to dramatic improvements. Riley55 initially treated 27 patients with Graves’ ophthalmopathy of moderate severity with methylprednisolone acetate every 2 weeks, and later with Celestone Soluspan® every 3 to 4 days. Finally, he administered a mixture of the 2 substances every 7 to 10 days. He reported slight improvement and warned against a long duration of treatment because of side effects.
Epidural (interlaminar, intraforaminal, and caudal) steroid injections for back pain and sciatica
Harald Breivik, William I Campbell, Michael K Nicholas in Clinical Pain Management, 2008
Inadvertent intravascular injection of particulate steroids has been reported to cause cerebrovascular accidents, retinal infarcts, and deafness81 from the formation of microembolae. Methylprednisolone acetate forms aggregates when dissolved in local anesthetics more than other depot steroids.11
Improvement of bone microarchitecture in methylprednisolone induced rat model of osteoporosis by using thiolated chitosan-based risedronate mucoadhesive film
Published in Drug Development and Industrial Pharmacy, 2018
Dhrubojyoti Mukherjee, Bharath Srinivasan, J. Anbu, Mohammad Azamthulla, Venkatesh Teja Banala, S. G. Ramachandra
Risedronate sodium was a gift sample from Fleming Laboratories, Hyderabad, India. Chitosan was procured from Indian Institute of Fisheries, Cochin, India. HPMC-4 KM, ethylcellulose and thioglycolic acid (TGA) were obtained commercially from SD Fine Chemicals, Mumbai, India. Dialysis membrane-70 was procured from Hi Media Laboratories Pvt. Ltd., Mumbai, India. Ketamine HCl and Lidocaine HCl were obtained from Neon Laboratories Limited, Mumbai, India. Methylprednisolone acetate was obtained from Pfizer Products Pvt. Ltd, Mumbai, India. All other reagents and chemicals used were of analytical reagent grade.
Improved treatment efficacy of risedronate functionalized chitosan nanoparticles in osteoporosis: formulation development, in vivo, and molecular modelling studies
Published in Journal of Microencapsulation, 2019
Shivalingappa Santhosh, Dhrubojyoti Mukherjee, Jayaraman Anbu, Manikanta Murahari, Banala Venkatesh Teja
Risedronate sodium was gifted by Fleming Laboratories, Hyderabad, India. Medium molecular weight chitosan (Mw = 190–310 KDa, 85% deacetylated) was purchased from Indian Institute of Fisheries, Cochin, India. Sodium hydroxide was purchased from Vetec, Bangalore, India. Sodium orthophosphate was obtained commercially from Himedia Laboratories Pvt. Ltd., Mumbai, India. Methylprednisolone acetate was purchased from Pfizer products Pvt. Ltd, Mumbai, India. Lidocaine HCl and Ketamine HCl were purchased from Neon laboratories limited, Andheri, Mumbai, India. All other reagents were of analytical reagent grade.
Comparative safety review of current treatment options for chronic low back pain and unmet needs: a narrative review
Published in Expert Opinion on Drug Safety, 2021
Filip Jovanovic, Iulia Pirvulescu, Emilija Knezevic, Kenneth D. Candido, Nebojsa Nick Knezevic
Friedman et al. conducted a double-blind, placebo-controlled RCT on the intramuscular injection of methylprednisolone acetate on 82 patients presenting with LBP. Adverse medication effects one week after discharge were reported by 32% in the methylprednisolone group and 24% in the placebo group. In the steroid group, the AEs included drowsiness (15.3%), stomach pain (11.1%) and mood changes (2.5%) [10]. Candido et al. assigned 106 patients with unilateral lumbosacral radiculopathic pain to receive a lumbar interlaminar epidural injection, either midline (MIL) or lateral parasagittal (PIL), of 120 mg of methylprednisolone acetate and 1 ml of 1% lidocaine. They found that 12% of the MIL group and 22% of the PIL group experienced headaches (nonpositional and unrelated to dural puncture). Nausea was experienced by 14% of the MIL group and 6% of the PIL group. There was no significant difference between the groups in terms of AE frequency [11]. Nguyen et al. conducted a double-blind, placebo-controlled RCT on 135 patients with CLBP associated with active discopathy. The intervention group received an intradiscal injection of 25 mg prednisolone acetate during discography. The investigators monitored the safety profile of both groups, up to a one-year follow-up. At least one AE was reported by 97% of the steroid group and 94% of the control group. Furthermore, 78 serious AEs were reported in each group, which include hospitalizations for usual care of CLBP (25 in the steroid group and 29 in the control group), hospitalizations for events unrelated to CLBP (14 in the steroid group and 5 in the control group), events unrelated to CLBP without hospitalization (3 in the steroid group and 1 in the control group), and 1 event possibly related to the intervention in the control group (increase in sciatica pain in the 24 hours after the intervention) [12].
Related Knowledge Centers
- Acetate
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- Organic Compound
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- Methylprednisolone
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- Suspension
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