Previously, Dr. Levi and Dr. Horn published research on an innovative technique to improve the safety and accuracy of a commonly performed type of spine injection procedure in the neck called a cervical transforaminal epidural steroid injection. Last year, they published another article demonstrating the high level of safety and low level of patient discomfort experienced during this procedure using this new technique they developed. Most recently, in April 2023, they published another study showing that the MRI measurement required to perform this new technique has good inter-rater reliability, meaning it can be performed accurately by most physicians who perform this type of injection.
David Levi MD, Scott Horn DO, Dustin Runzo BS, Madeline Linn BS. Inter-rater reliability of MRI superior articular process angle measurement for use in the modified approach to cervical transforaminal epidural steroid injections. Interventional Pain Medicine. 2023; Vol 2(1).
In another area of research, certain steroids are felt, theoretically, to be safer for different types of spinal injection procedures. Dr. Levi, Dr Horn, and Jestine Murphy published a report in April 2023 confirming the safety of a specific steroid used around spinal arteries. This report has large implications for the steroid choice of spinal injection procedures.
David Levi MD, Scott Horn DO, Jestine Murphy BS, Josh Levin MD. Safety of dexamethasone in transforaminal epidural steroid injections: A case of temporary paraplegia caused by injection of lidocaine and dexamethasone into a lumbar radiculomedullary artery, with no neurologic sequelae. Interventional Pain Medicine. 2023; Vol 2 (1).
In addition, Dr. Levi published an important research study with his colleagues at Stanford University School of Medicine. They looked at a specific MRI finding which likely indicates a source of pain from the bones above and below the spinal discs. Some patients have a very specific pattern to their low back pain in which they ‘throw their back out’ and have severe episodes lasting for days to weeks. This type of pain did not correlate to the MRI finding on the vertebral bones. Dr. Levi and Dr Horn previously demonstrated in a prior study demonstrating that this type of “episodic” pain is due to small tears in the spinal disc itself.
Levin J, Schirmer D, Garcia R, Levi D. Is a history of episodic low back pain an indicator of Modic changes? Interventional Pain Medicine. 2023; Vol 2 (1).
Levi D, Horn S, Carnahan D, Levin J. Is severe episodic low back pain a sign of discogenic etiology? Pain Medicine 2018;19(7):1334–39.