International Pain and Spine Intervention Society Emergency Protocols: Intra-arterial Injection

Published on June 19, 2026

Interv Pain Med. 2026 Jun 11;5(2):100776. doi: 10.1016/j.inpm.2026.100776. eCollection 2026 Jun.

ABSTRACT

This protocol discusses the risks associated with inadvertent intra-arterial injection during spine interventions, including stroke, seizure, spinal cord infarction, and paralysis. It highlights the dangers of particulate steroid embolism and arterial vasospasm, particularly during transforaminal injections. The protocol focuses on immediate recognition, termination of the procedure, activating stroke protocols, neurologic assessment, airway management, and rapid transfer for advanced neurologic care.

PMID:42317769 | PMC:PMC13273698 | DOI:10.1016/j.inpm.2026.100776

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