Clinical Classification as a Predictor of Therapeutic Outcome After Cervical Epidural Steroid Injection

Ferrante, F. Michael; Wilson, Saydra; Iacobo, C.; Orav, E. John; Rocco, Angelo G.; Lipson, Stephen J.

doi:10.1097/00007632-199305000-00010

Cited by 129 publications

(86 citation statements)

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“…On reviewing 100 patients who underwent cervical epidural steroid injections, Ferrante et al [2] concluded that patients with radicular symptoms and signs experienced better pain relief than those with neck pain. There is also a trend that shows that the effect of CIESI on radiculopathy was superior to its effect on neck pain in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Cervical interlaminar epidural steroid injections (CIESIs) are being used for the conservative management of neck pain or cervical radiculopathy [1][2][3][4]. These injections are often performed in a "blind" manner, i.e., without fluoroscopic guidance.…”

mentioning

confidence: 99%

“…Several reports have been issued on the long-term effects of repeated CIESIs [1,2], but no report is available on its short-term effects. Knowledge of the short-term effects of this procedure would improve rapport with patients and enable us to predict long-term effects.…”

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confidence: 99%

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

et al. 2007

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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 fivepoint 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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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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

et al. 2007

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“…Their use should be reserved for clear radicular pain (recommendation strength B). 37,40 Some recommending bodies support the use of epidural steroid injections, 28 whereas others do not. 25 Small trials of the clinical efficacy of systemic steroids have been inconclusive, 37 and clinical trials comparing oral and epidural steroids have not been performed.…”

Section: Steroidsmentioning

confidence: 99%

Evaluation and Treatment of Posterior Neck Pain in Family Practice

Douglass¹,

Bope²

2004

The Journal of the American Board of Family Medicine

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“…Fıtıklaşmış nukleus pulposustan salınan mediatörlerle araşidonik asit kaskadının tetiklenmesi sonucu ortaya çıkan intraspinal enflamasyonun geriletilmesi, steroid tedavisinin temel amacıdır ve yüksek dozda kortikosteroidlerin doğrudan epidural alana uygulanmasını gerektirmektedir. [6][7][8] Lumbar disk fıtığı nedeni ile epidural steroid enjeksiyonunun etkinliği oldukça geniş araştırılmış olmakla birlikte SESİ uygulamaları ile ilgili çalışma sayısı oldukça az sayıdadır. [6,8,9] Bu çalışmada, kliniğimizde 2008-2009 tarihleri arasında semptomatik servikal disk fıtığına bağlı radikülopati tedavisinde uyguladığımız interlaminar SESİ tedavisinin altı aylık sonuçları geriye dönük olarak değerlendirildi.…”

Section: Introductionunclassified

Cervical epidural steroid injections for symptomatic disc herniations

Usta

Muslu²,

Demircioğlu³

et al. 2012

Agri

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Summary Objectives: Cervical radiculopathy is widespread in society, and the methods used in the treatment cover a wide range from conservative treatment to surgical treatment. There is not yet a full consensus on the use of invasive approaches ÖzetAmaç: Servikal radikülopati toplumda yaygın olup, tedavisinde kullanılan yöntemler konservatif tedaviden cerrahi tedaviye kadar geniş bir aralıkta yer almaktadır. Optimal radiküler ağrı tedavisinde invaziv yaklaşımlar açısından henüz tam bir fikir birliği bulunmamaktadır. Servikal diskopati semptomları gösteren hastalarda servikal epidural steroid injeksiyonu (SESİ) bu tedavi yaklaşımlarından birisidir. Gereç ve Yöntem:Bir yıllık dönem içerisinde semptomatik servikal radikülopati tanısı almış 58 hastaya uygulanan SESİ tedavisinin 6 aylık dönemdeki sonuçları geriye dönük olarak incelendi. Hastalar oturur ve baş fleksiyon pozisyonda iken standart sterilizasyon sonrası C7-T1 aralığından median yaklaşım ve asılı damla tekniği kullanılarak epidural aralığa girildi ve daha önceden hazırlanan, içerisinde 80 mg triamsinolon ile 10 mg levobupivakainin bulunduğu 6 ml'lik solüsyon enjekte edildi.Bulgular: SESİ uygulaması sonrası hastaların vizüel analog skala (VAS) değerlerinin tedavi öncesi değerlere göre anlamlı olarak daha düşük bulundu. SESİ tedavisinde başarı oranları 1., 3. ve 6. ayda sırasıyla %93, %86 ve %72 idi.Sonuç: SESİ uygulaması servikal radikülopati tedavisinde etkili bir yöntemdir ve hastaların cerrahiye ihtiyaç duyma oranlarını düşürmektedir.Anahtar sözcükler: Ağrı skoru; hasta memnuniyeti; servikal epidural steroid enjeksiyonu.

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Clinical Classification as a Predictor of Therapeutic Outcome After Cervical Epidural Steroid Injection

Cited by 129 publications

References 0 publications

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

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

Evaluation and Treatment of Posterior Neck Pain in Family Practice

Cervical epidural steroid injections for symptomatic disc herniations

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