Thoracic transforaminal epidural steroid injection for management of thoracic spine pain: A multicenter cross-sectional study of short-term outcomes

Levin, Josh; Chan, John; Huynh, Lisa; Smuck, Matthew; Koltsov, Jayme; Kesikburun, Bilge; Wagner, Graham E.; Caragea, Marc; Kuo, Keith; McCormick, Zachary L.; Schneider, Byron J.; Berlin, Evan; Kennedy, David J.; Kesikburun, Serdar

doi:10.1016/j.inpm.2021.100004

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…Conservative treatments include PT, weight loss, and mindfulness [ 1 , 18 ]. Data is also sparse on more interventional treatments, such as epidural steroid injections or surgical decompression [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Physical Therapy to Alleviate Symptomatic Thoracic Radiculopathy: A Systematic Review and Meta-Narrative Analysis

Mostert,

Perera,

Higano

et al. 2024

Ann Rehabil Med

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To evaluate the efficacy of physical therapy (PT) to alleviate symptomatic thoracic radiculopathy (TR) without the use of invasive procedures. Database search was conducted by an experienced medical librarian from inception until January 27, 2023, in EBSCO CINAHL with Full Text, Ovid Cochrane Central Register of Controlled Trials, Ovid Embase, Ovid MEDLINE, Scopus, and Web of Science Core Collection. Inclusion criteria included studies that involved adult patients (age≥18) who had a magnetic resonance imaging-confirmed TR and underwent a structured, supervised PT program of any length. All types of studies were included. Study quality and risk of bias were assessed using the National Heart, Lung, and Blood Institute (NHLBI) Study Quality of Assessment Tool. Certainty in evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. A meta-analysis was not performed. A total of 1,491 studies were screened and 7 studies met inclusion criteria, 5 case studies and 2 cohort studies. All studies showed improvement or resolution of the TR with PT. Quantitative improvements were not noted in most studies and PT regimens were sparsely described. Overall quality assessment demonstrated 3 studies had “good,” 1 “fair,” and 3 “poor” quality evidence. Certainty of evidence was “low” due to risk of bias. A dedicated PT program may help to alleviate symptomatic TR; however due to limited evidence, risk of bias, and low certainty in evidence, the data is too weak to support a definite conclusion.

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Section: Discussionmentioning

confidence: 99%

The Efficacy of Physical Therapy to Alleviate Symptomatic Thoracic Radiculopathy: A Systematic Review and Meta-Narrative Analysis

Mostert,

Perera,

Higano

et al. 2024

Ann Rehabil Med

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“…[18,19] For HTD, there are no consensus guidelines, and the literature on the topic is sparse. [20,21] Further investigations and evidence-based consensus guidelines are necessary. Our 2 patients experienced considerable symptomatic relief of a 50% reduction in NRS following thoracic transforaminal epidural blocks with steroid or hypertonic saline.…”

Section: Discussionmentioning

confidence: 99%

Unusual presentations of thoracic disc herniation treated by thoracic epidural block: Case reports

Woo

et al. 2022

Medicine

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Rationale: Herniation of the thoracic intervertebral disc (HTD) is a rare disease that accounts for <1% of all disc herniations. Physicians may make diagnostic errors due to the variable clinical features and limited experience of HTD. In this report, we present 2 unusual cases of HTD. Patient concerns: A 72-year-old woman (case 1) visited our pain clinic because of chronic abdominal discomfort with visible bulging on the left side. Atrophy of the abdominal wall muscle and quadratus lumborum was observed. The therapeutic effect of interfascial plane block to exclude the possibility of truncal neuropathy following muscular atrophy was temporary. The other patient, a 75-year-old man (case 2) complained of aggravation of previously diagnosed postherpetic neuralgia. An extension of the previously symptomatic area of the forward upper dermatome was observed. Radiofrequency treatment on the symptomatic dorsal root ganglion failed to relieve symptoms. Diagnoses: Two patients underwent magnetic resonance imaging of the spine for further evaluation. The patients were diagnosed with multilevel HTD and foraminal herniated disc, compatible with their symptoms and without myelopathy. Interventions: Two patients were conservatively treated with a fluoroscopy-guided transforaminal epidural block. Outcomes: The 2 patients experienced significant pain reduction up to 50% on a numeric rating scale after repeated treatment. Lessons: Multilevel HTD of the mid- to lower-thoracic spine may present as abdominal bulging with atrophy of the abdominal wall muscles. We also report another case of concomitant symptomatic thoracic radiculopathy from HTD and postherpetic neuralgia at the adjacent level. Thoracic transforaminal epidural block may be considered a conservative therapeutic approach for HTD.

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“…Подход к терапии торакальных радикулопатий зависит от выраженности боли, ее длительности (острая, хроническая) и наличия сопутствующих заболеваний. Учитывая отсутствие специфических рекомендаций для данной локализации поражения, обычно используются методы лечения, аналогичные таковым при дискогенной пояснично-крестцовой радикулопатии [31,32]. Особое значение в терапии пациентов с корешковыми поражениями на грудном уровне в последние годы приобрели трансфораминальные эпидуральные инъекции кортикостероидов, выполняемые под контролем различных визуализационных техник [33].…”

Section: этиология боли в передней брюшной стенкеunclassified

Anterior Abdominal Wall Pain

Dolgushina,

Karpova,

Karpov

et al. 2023

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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Aim: to present modern approaches to the differential diagnosis and treatment of anterior abdominal wall pain.Key points. Pain in the anterior abdominal wall is a common reason for visiting a gastroenterologist and is often misinterpreted. Signs that distinguish it from visceral and parietal pain include local character, a positive Carnett sign and the effectiveness of local anesthetic injection. Among the main causes, it is necessary to highlight diseases that are not accompanied by a palpable mass in the anterior abdominal wall (anterior cutaneous nerve entrapment syndrome, ilioinguinal nerve syndrome, slipping rib syndrome, radiculopathy and myofascial pain syndrome). Another group of causes of pain in the anterior abdominal wall is represented by diseases in which areas of infiltration (tumors, endometriosis, infections) or hernial protrusions are determined, in which radiation methods play an important role in diagnosis.Conclusion. Knowledge of pathognomonic clinical and instrumental signs is the basis for differential diagnosis and choice of treatment strategy for pathology of the anterior abdominal wall.

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Thoracic transforaminal epidural steroid injection for management of thoracic spine pain: A multicenter cross-sectional study of short-term outcomes

Cited by 3 publications

References 20 publications

The Efficacy of Physical Therapy to Alleviate Symptomatic Thoracic Radiculopathy: A Systematic Review and Meta-Narrative Analysis

The Efficacy of Physical Therapy to Alleviate Symptomatic Thoracic Radiculopathy: A Systematic Review and Meta-Narrative Analysis

Unusual presentations of thoracic disc herniation treated by thoracic epidural block: Case reports

Anterior Abdominal Wall Pain

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