Effect of Cervical Interlaminar Epidural Steroid Injection: Analysis According to the Neck Pain Patterns and MRI Findings.
- Author:
Ji Won CHOI
1
;
Hyung Woo LIM
;
Jin Young LEE
;
Won Il LEE
;
Eun Kyung LEE
;
Choo Hoon CHANG
;
Jae Young YANG
;
Woo Seog SIM
Author Information
- Publication Type:Original Article
- Keywords: Axial neck pain; Cervical epidural steroid injection; Herniated intervertebral disc; Magnetic resonance imaging; Radicular pain; Spinal stenosis
- MeSH: Constriction, Pathologic; Fluoroscopy; Humans; Intervertebral Disc; Magnetic Resonance Imaging*; Medical Records; Neck Pain*; Neck*; Retrospective Studies; Spinal Stenosis; Visual Analog Scale
- From:The Korean Journal of Pain 2016;29(2):96-102
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: It is widely accepted that cervical interlaminar steroid injection (CIESI) is more effective in treating radicular pain than axial neck pain, but without direct comparison. And the differences of effect after CIESI according to MRI findings are inconsistent. In this retrospective study, we evaluated the therapeutic response of CIESI according to pain sites, durations, MRI findings, and other predictive factors altogether, unlike previous studies, which evaluated them separately. METHODS: The medical records of 128 patients who received fluoroscopy guided CIESI were analyzed. We evaluated the therapeutic response (more than a 50% reduction on the visual analog scale [VAS] by their second visit) after CIESI by (1) pain site; neck pain without radicular pain/radicular pain with or without neck pain, (2) pain duration; acute/chronic (more than 6 month), and (3) findings of MRI; herniated intervertebral disc (HIVD)/spinal stenosis, respectively and altogether. RESULTS: Eighty-eight patients (68%) responded to CIESI, and there were no significant differences in demographic data, initial VAS score, or laboratory findings. And there were no significant differences in the response rate relating to pain site, pain duration, or MRI findings, respectively. In additional analysis, acute radicular pain with HIVD patients showed significantly better response than chronic neck pain with spinal stenosis (P = 0.04). CONCLUSIONS: We cannot find any sole predictive factor of therapeutic response to the CIESI. But the patients having acute radicular pain with HIVD showed the best response, and those having other chronic neck pain showed the worst response to CIESI.
