Encyclopedia of Pain

2013 Edition
| Editors: Gerald F. Gebhart, Robert F. Schmidt

Cervical Transforaminal Injection of Steroids

  • James P. RathmellEmail author
Reference work entry
DOI: https://doi.org/10.1007/978-3-642-28753-4_651

Synonyms

Definition

 Cervical transforaminal injection of corticosteroids is a treatment for cervical  radicular pain in which corticosteroids are delivered into a cervical intervertebral neuroforamen.

Characteristics

Cervical radicular pain affects about one person per 1,000 of population, per year (Radhakrishnan et al. 1994), and is most often caused by a disc herniation or foraminal stenosis. Its natural history can be favorable (Bogduk et al. 1999), but not all patients recover naturally. For relieving cervical radicular pain, conservative therapy, typically including graduated exercise and oral analgesics, is supported only by observational studies, which have not controlled for natural history or nonspecific effects of treatment. The controlled studies that have been conducted have shown no significant benefit for traction or exercises (British Association of Physical Medicine 1966;...

This is a preview of subscription content, log in to check access.

References

  1. Ahlgren, B. R., & Garfin, S. R. (1996). Cervical radiculopathy. The Orthopedic Clinics of North America, 27, 253–263.PubMedGoogle Scholar
  2. Baker, R., Dreyfuss, P., Mercer, S., & Bogduk, N. (2002). Cervical transforaminal injection of corticosteroids into a radicular artery: A possible mechanism for spinal cord injury. Pain, 103, 211–215.Google Scholar
  3. Bogduk, N. (1999). Medical management of acute cervical radicular pain. An evidence-based approach. Newcastle Australia: Newcastle Bone and Joint Institute.Google Scholar
  4. Boyce, B. H., & Wang, J. C. (2003). Evaluation of neck pain, radiculopathy, and myelopathy: Imaging, conservative treatment, and surgical indications. Instructional Course Lectures, 52, 489–495.PubMedGoogle Scholar
  5. British Association of Physical Medicine. (1966). Pain in the neck and arm: A multicentre trial of the effects of physiotherapy. British Medical Journal, 1, 253–258.Google Scholar
  6. Brouwers, P. J. A. M., Kottnik, E. J. B. L., Simon, M. A. M., & Prevo, R. L. (2001). A cervical anterior spinal artery syndrome after diagnostic blockade of the right C6-nerve root. Pain, 91, 397–399.PubMedGoogle Scholar
  7. Bush, K., & Hillier, S. (1996). Outcome of cervical radiculopathy treated with periradicular/epidural corticosteroid injections: A prospective study with independent clinical review. European Spine Journal, 5, 319–325.PubMedGoogle Scholar
  8. Chestnut, R. M., Abithol, J. J., & Garfin, S. R. (1992). Surgical management of cervical radiculopathy. The Orthopedic Clinics of North America, 23, 461–474.Google Scholar
  9. Goldie, I., & Landquist, A. (1970). Evaluation of the effects of different forms of physiotherapy in cervical pain. Scandinavian Journal of Rehabilitation Medicine, 2–3, 117–121.Google Scholar
  10. Klaber Moffett, J. A., Hughes, G. I., & Griffiths, P. (1990). An investigation of the effects of cervical traction. Part 1: Clinical effectiveness. Clinical Rehabilitation, 4, 205–211.Google Scholar
  11. Radhakrishnan, K., Litchy, W. J., O’Fallon, W. M., & Kurland, L. T. (1994). Epidemiology of cervical radiculopathy. A population-based study of Rochester, Minnesota, 1976–1990. Brain, 117, 325–335.PubMedGoogle Scholar
  12. Rathmell, J. P., Aprill, C., & Bogduk, N. (2004). Cervical transforaminal injection of steroids. Anesthesiology, 100, 1595–1600.PubMedGoogle Scholar
  13. Slipman, C. W., Lipetz, J. S., Jackson, H. B., Rogers, D. P., & Vresilovic, E. J. (2000). Therapeutic selective nerve root block in the non-surgical treatment of atraumatic cervical spondylotic radicular pain: A retrospective analysis with independent clinical review. Archives of Physical Medicine and Rehabilitation, 81, 741–746.PubMedGoogle Scholar
  14. Slipman, C. W., Plastaras, C. T., Palmitier, R. A., Huston, C. W., & Sterenfeld, E. B. (1998). Symptom provocation of fluoroscopically guided cervical nerve root stimulation. Are dynatomal maps identical to dermatomal maps? Spine, 23, 2235–2242.PubMedGoogle Scholar
  15. Vallee, J. N., Feydy, A., Carlier, R. Y., Mutschler, C., Mompoint, D., & Vallee, C. A. (2001). Chronic cervical radiculopathy: Lateral approach periradicular corticosteroid injection. Radiology, 218, 886–892.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of Vermont College of MedicineBurlingtonUSA