Clinical Outcomes of Cervical Transforaminal Epidural Block Using Local Anesthetics with or without a Steroid for Cervical Spondylotic Radiculopathy
10.4184/jkss.2020.27.4.115
- Author:
Eugene J. PARK
1
;
Seong-Min KIM
;
Seungho CHUNG
;
Woo-Kie MIN
Author Information
1. Department of Orthopedic Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
- Publication Type:Original Article
- From:Journal of Korean Society of Spine Surgery
2020;27(4):115-124
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objectives:To evaluate and compare the clinical outcomes of cervical transforaminal epidural block (CTEB) using local anesthetics with or without a steroid for cervical spondylotic radiculopathy (CSR).Summary of Literature Review: The typical mixture for a CTEB is a combination of local anesthetics with a non-particulate steroid.However, there are potential complications related to steroid injections such as steroid-induced osteoporosis, hypothalamus-pituitaryadrenal gland axis suppression, and hyperglycemia.
Materials and Methods:From January 2018 to October 2019, 35 patients who underwent CTEB for CSR were enrolled in this study.Cases with arm pain over 4 on a visual analog scale (VAS) were included. In the first 19 cases, a combination of 1 mL of 1% lidocaine and 1 mL of dexamethasone was used (group A), and in the next 16 cases, 1 mL of 1% lidocaine mixed with 1 mL of normal saline was used (group B). Arm pain VAS and the Neck Disability Index (NDI) were obtained perioperatively.
Results:Baseline characteristics were not significantly different between the two groups. In both groups, the arm pain VAS significantly decreased at 30 minutes, 2 weeks, and 6 weeks post-injection compared to pre-injection values. However, the arm pain aggravated 12 weeks post-injection. The NDI of both groups significantly improved 6 weeks post-injection compared to pre-injection. The clinical outcomes of arm pain VAS and NDI at 30 minutes, 2 weeks, and 6 weeks post-injection, as well as the amounts of change, were not significantly different between both groups.
Conclusions:CTEB for CSR without a steroid improved symptoms by 6 weeks. The degree of improvement was similar to when CTEB was performed with a steroid in terms of VAS and NDI.
