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Cervical interlaminar epidural steroid injection for neck pain and cervical radiculopathy: effect and prognostic factors

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Abstract

Objective

To verify the usefulness of a fluoroscopy guided cervical interlaminar epidural steroid injection (CIESI) in patients with neck pain and cervical radiculopathy and to evaluate outcome predictors.

Design

We retrospectively analyzed 91 patients from July 2004 to June 2005 in whom CIESI was initially performed for neck pain and cervical radiculopathy. Therapeutic effects were evaluated 2 weeks after the administration of CIESI, and CIESI effectiveness was graded using a five-point scale, namely, whether the pain had disappeared, was much improved, slightly improved, the same, or aggravated. We also used a visual analog scale (VAS) for the clinical evaluation. According to documentation and follow-up charts, we categorized treatments as effective or ineffective. Possible outcome predictors, namely, diagnosis (spinal stenosis vs herniated disc), primary symptoms (neck pain vs radiculopathy vs both), age, gender, and duration of pain (more or less than 6 months) were also analyzed. Fisher’s exact test, the chi-square test, and multiple logistic regression analysis were used for the statistical analysis.

Patients

After their medical records had been reviewed, 76 patients were included in this study. Inclusion criteria were: the availability of a cross-sectional image, such as a CT scan or an MR image, and a follow-up record after injection.

Results and conclusions

The medical records of 76 patients (male:female = 41 : 35) of mean age 53.1 years (range 32 years to 82 years) were reviewed. Two weeks after injection, 55 patients (72.4%) had experienced effective pain relief. Patients with herniated discs had significantly better results than patients with spinal stenosis (86.1% vs 60.0%) (P < 0.05). Other non-significant predictors of an improved outcome included: a symptom duration of <6 months, a young age, and the presence of cervical radiculopathy. Multiple regression analysis showed that the only factor that was significantly associated with outcome was the cause of the pain, i.e., herniated disc or spinal stenosis. Fluoroscopy guided CIESI is a safe and effective means of treating patients with neck pain and cervical radiculopathy. The most important outcome predictor was cause of pain, and patients with herniated disc experienced better pain relief than those with spinal stenosis.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Bundang Hospital, 300 Gumidong, Bundang-Gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea

    Jong Won Kwon, Joon Woo Lee, Sung Hyun Kim, Kyu-Sung Kwack & Heung Sik Kang

  2. Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea

    Ja-Young Choi, Sung Gyu Moon, Woo Sun Jun & Heung Sik Kang

  3. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Gyeongi-Do, South Korea

    Jin-Sup Yeom

  4. Department of Neurosurgery, Seoul National University Bundang Hospital, Gyeongi-Do, South Korea

    Hyun-Jib Kim

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  1. Jong Won Kwon
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  2. Joon Woo Lee
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Correspondence to Joon Woo Lee.

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Kwon, J.W., Lee, J.W., Kim, S.H. et al. Cervical interlaminar epidural steroid injection for neck pain and cervical radiculopathy: effect and prognostic factors. Skeletal Radiol 36, 431–436 (2007). https://doi.org/10.1007/s00256-006-0258-2

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  • DOI: https://doi.org/10.1007/s00256-006-0258-2

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