Long-term effectiveness of transforaminal anterolateral approach CT-guided cervical epidural steroid injections for cervical radiculopathy treatment

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Aldin, Z.Radiology Department, Princess Alexandra NHS Trust, Hamstel Road, Harlow, Essex, United Kingdom (author)

Long-term effectiveness of transforaminal anterolateral approach CT-guided cervical epidural steroid injections for cervical radiculopathy treatment

Article/chapterEnglish2024

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Elsevier,2024
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LIBRIS-ID:oai:DiVA.org:umu-221658
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-221658URI
https://doi.org/10.1016/j.crad.2024.01.022DOI

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Language:English
Summary in:English

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Aim: To evaluate the long-term clinical effectiveness of computed tomography (CT)-guided transforaminal cervical epidural steroid injection using an anterolateral approach for the treatment of cervical radiculopathy (CR) using well-established robust clinical scoring systems for neck pain and neck disability. Despite its widespread use, evidence to support the long-term benefit of routine cervical epidural steroid injection is currently very limited.Materials and methods: This study included 113 patients with magnetic resonance imaging (MRI)-confirmed CR who underwent a steroid injection at a single cervical level via a unilateral transforaminal anterolateral approach. Pain was assessed quantitatively at pre-injection, 15 minutes post-injection, 1 month, 3 months, and at 1 year. Neck disability was assessed using the Oswestry Neck Disability Index (NDI) at pre-injection, 1 month, 3 months, and 1 year time points.Results: Eighty patients completed the study. Sixty per cent reported reduced neck pain (mean pain reduction, 55%), which was clinically significant in 45% cases. Furthermore, 66% reported an improvement in neck disability (mean improvement, 51%), which was clinically significant for 56% patients. Clinically significant good outcomes in both neck pain and neck disability were evident from as early as 1-month, and importantly, were independent both of pre-treatment CR characteristics (including severity of pre-injection neck pain or disability) and of findings on pre-injection MRI imaging.Conclusion: Transforaminal anterolateral approach CT-guided epidural steroid injection resulted in a clinically significant long-term improvement in both neck pain and disability for half of the present cohort of patients with unilateral single-level CR. This improvement was independent of the severity of the initial symptoms and pre-injection MRI findings.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Ortopedi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Orthopaedics hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Sjukgymnastik hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Physiotherapy hsv//eng

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Diss, J.K.Radiology Department, Princess Alexandra NHS Trust, Hamstel Road, Harlow, Essex, United Kingdom (author)
Mahmood, H.Imaging Department, Chelsea and Westminster Hospital NHS Foundation Trust, Chelsea and Westminster Hospital, Chelsea, London, United Kingdom (author)
Sadik, T.Orthopaedic/Spinal Surgery Department, Princess Alexandra NHS Trust, Hamstel Road, Harlow, Essex, United Kingdom (author)
Basra, H.Radiology Department, Princess Alexandra NHS Trust, Hamstel Road, Harlow, Essex, United Kingdom (author)
Ahmed, M.Orthopaedic/Spinal Surgery Department, Princess Alexandra NHS Trust, Hamstel Road, Harlow, Essex, United Kingdom (author)
Danawi, Z.Department of Trauma and Orthopaedics, Southend University Hospital, Southend, Essex, United Kingdom (author)
Gul, A.Orthopaedic/Spinal Surgery Department, Princess Alexandra NHS Trust, Hamstel Road, Harlow, Essex, United Kingdom (author)
Sayed-Noor, A.SUmeå universitet,Ortopedi,Clinical Sciences Department, College of Medicine, University of Sharjah, United Arab Emirates(Swepub:umu)arss0001 (author)
Radiology Department, Princess Alexandra NHS Trust, Hamstel Road, Harlow, Essex, United KingdomImaging Department, Chelsea and Westminster Hospital NHS Foundation Trust, Chelsea and Westminster Hospital, Chelsea, London, United Kingdom (creator_code:org_t)

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In:Clinical Radiology: Elsevier79:5, s. e775-e7830009-92601365-229X

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By the author/editor: Aldin, Z.; Diss, J.K.; Mahmood, H.; Sadik, T.; Basra, H.; Ahmed, M.; show more...; Danawi, Z.; Gul, A.; Sayed-Noor, A.S; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Orthopaedics

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Physiotherapy

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