Best Practices for Coping With Dexamethasone Shortages

The Spine Intervention Society has outlined best practice recommendations to maximize safety while performing epidural steroid injections during preservative-free dexamethasone shortages, like the one we are currently experiencing. These recommendations are designed to assist physicians who may be considering alternative steroid preparations or different approaches to the epidural space.

 It is critical that physicians carefully weigh the risks and benefits of using alternative agents or approaches for epidural steroid injections and involve each patient in the process of shared decision making before proceeding.

 For a summary of the evidence supporting a variety of procedures, along with detailed descriptions of techniques with high-quality radiographic images depicting needle placement and injectate flow patterns, please refer to the SIS Guidelines.