Comparison of three CT-guided epidural steroid injection approaches in 104 patients with cervical radicular pain: transforaminal anterolateral, posterolateral, and transfacet indirect.

Détails

ID Serval
serval:BIB_B53B6D93DB68
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Comparison of three CT-guided epidural steroid injection approaches in 104 patients with cervical radicular pain: transforaminal anterolateral, posterolateral, and transfacet indirect.
Périodique
Skeletal radiology
Auteur(s)
Bise S., Pesquer L., Feldis M., Bou Antoun M., Silvestre A., Hocquelet A., Dallaudière B.
ISSN
1432-2161 (Electronic)
ISSN-L
0364-2348
Statut éditorial
Publié
Date de publication
12/2018
Peer-reviewed
Oui
Volume
47
Numéro
12
Pages
1625-1633
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Résumé
The treatment of persistent cervical radicular pain (CRP) by CT-guided epidural steroid injections (CTESI) by a transforaminal anterolateral (TFA) approach is associated with rare but serious complications. Two recently described transforaminal posterolateral (TFP) and transfacet indirect (TFT) approaches may be safer options, but have not been extensively evaluated. We compared the efficacy of three CTESI approaches (TFA, TFP, and TFT) in the treatment of persistent CRP (>6 weeks).
Patients were prospectively assessed for pain using the visual analog scale (VAS) and for functional disability by the Neck Disability Index (NDI) before treatment, then 6 weeks and 6 months after CTESI.
A total of 104 patients were included (n = 30 TFA, n = 36 TFP, and n = 38 TFT approaches). Each group was found to have a statistically significant improvement at 6 weeks (median VAS values: 7 (2-9) at D0 and 2 (3-6) at 6 weeks p < 0.01; median NDI values: 38 (24-50) at D0 and 29 (18-42) at 6 weeks (p < 0.01)), and at 6 months (median VAS values: 7 (2-9) at D0 and 4 (2-6) at 6 months (p < 0.01); median NDI values: 38 (24-50) at D0 and 28 (13-40) at 6 months (p < 0.01)). No significant difference was observed in the decrease in VAS and NDI scores among the three approaches at 6 weeks (p = 0.635 and p = 0.54 for VAS and NDI respectively) or 6 months (p = 0.704 and p = 0.315 for VAS and NDI respectively). No major complications were noted.
The results of CTESI using the TFP or TFT approach are similar to those for TFA in the treatment of persistent CRP and could be a safer option.
Mots-clé
Adult, Contrast Media, Disability Evaluation, Female, Humans, Injections, Epidural/methods, Iopamidol, Magnetic Resonance Imaging, Male, Middle Aged, Neck Pain/diagnostic imaging, Neck Pain/drug therapy, Pain Measurement, Prospective Studies, Radiculopathy/diagnostic imaging, Radiculopathy/drug therapy, Radiography, Interventional, Steroids/administration & dosage, Tomography, X-Ray Computed, Treatment Outcome, Approaches, CT-guided, Cervical, Injection, Pain, Radicular, Steroid
Pubmed
Web of science
Création de la notice
21/08/2018 18:27
Dernière modification de la notice
20/08/2019 16:23
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