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The preliminary results of a new CT-guided periradicular cervical steroid injection technique: safety and feasibility of the lateral peri-isthmic approach in 28 patients

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Abstract

Background

Computed tomography (CT)-guided cervical nerve injections are broadly being used in the treatment of cervical radiculopathy; however, catastrophic complications have been reported. Herein, we aimed to evaluate the efficacy, feasibility, and safety of a novel CT-guided cervical injection technique.

Materials and methods

We prospectively performed cervical injections in 28 patients with cervical radiculopathies using a novel CT-guided cervical transforaminal injection technique; lateral peri-isthmic approach in which the tip of the needle advanced to the lateral cortex of the isthmus instead of the foraminal area. Patients’ pain reduction rates were evaluated using visual analog scores (VAS) at pre-treatment, immediately after treatment, at 3 weeks and 6 months after the treatment. Intra-vascular contrast medium injections and distribution of the contrast material into the foraminal, epidural or extraforaminal area during the procedure were noted.

Results

Pre-treatment pain scores were reduced by 4.2 ± 1.4 (p < 0.001), 3.9 ± 1.37 (p < 0.001) and 3.25 ± 1.53 (p < 0.001) immediately after the treatment, 3 weeks and 6 months after the treatment respectively. The number of patients with >50% pain relief as measured by VAS were 21 (75%) immediately after the procedure, 19 (67.8%) at 3 weeks and 17 (60%) at 6 months after the procedure. The injected contrast material was dispersed into the neural foramen in 9 cases (32.1%), the foraminal and epidural area in 14 cases (50%) and the extraforaminal area in 5 cases (17.9%).

Conclusion

The CT-guided lateral peri-isthmic approach seems to be a secure and feasible method for cervical injections with satisfactory pain reduction.

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Authors and Affiliations

  1. Department of Radiology, Istanbul Florence Nightingale Hospital, Istanbul, Turkey

    Onur Levent Ulusoy, Ayhan Mutlu & Mustafa Sirvanci

  2. Cerrahpasa Medical Faculty, Department of Radiology, Istanbul University, Istanbul, Turkey

    Deniz Alis

  3. Department of Radiology, American Hospital, Istanbul, Turkey

    Bulent Colakoglu

Authors
  1. Onur Levent Ulusoy
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  2. Deniz Alis
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  3. Ayhan Mutlu
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  4. Bulent Colakoglu
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  5. Mustafa Sirvanci
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Corresponding author

Correspondence to Onur Levent Ulusoy.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The local ethics committee approved this prospective study and written informed consent was obtained from all patients.

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Ulusoy, O.L., Alis, D., Mutlu, A. et al. The preliminary results of a new CT-guided periradicular cervical steroid injection technique: safety and feasibility of the lateral peri-isthmic approach in 28 patients. Skeletal Radiol 47, 1607–1613 (2018). https://doi.org/10.1007/s00256-018-2986-5

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  • DOI: https://doi.org/10.1007/s00256-018-2986-5

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