Document Detail

Transforaminal steroid injections in the treatment of cervical radiculopathy. A prospective outcome study.
MedLine Citation:
PMID:  15924210     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aim of this study was to assess if transforaminal steroid injections applied to cohort of patients waiting for cervical disc surgery, reduce the pain of cervical radiculopathy and hence reduce the need for surgical intervention. Cervical radiculopathy due to cervical disc herniation or spondylosis is a common indication for cervical disc surgery. Surgery is however not always successful, and is not done without risk of complications. Transforaminal injection of steroids has gained popularity due to the rationale that inflammation of the spinal nerve roots causes radicular pain, and therefore steroids placed locally should relieve symptoms. METHODS: During a 12-month period, 21 secondary referral patients with unilateral cervical radiculopathy entered the study. Cervical disc herniation or spondylosis affecting the corresponding nerve root was demonstrated by appropriate investigation (MRI or myelography). The patients then received 2 transforaminal steroid injections, at 2 weeks interval, while waiting for operative treatment. The pain intensity (VAS), Odom's criteria and operative indications were registered at 6 weeks and 4 months. FINDINGS: After receiving injection treatment 5 of the 21 patients decided to cancel the operation due to clinical improvement. A statistically significant reduction (0.02) in radicular pain score was simultaneously measured. This corresponds well with the reduction in operative requirements since radicular pain is the main indication for operative treatment. The responders experienced a long-lasting effect. Those responding positively however improved neck pain to the same extent as radicular pain, and patients with cervical spondylosis responded as positively as those with disc herniation. INTERPRETATION: This prospective cohort study indicates a reduction in the need for operative treatment due to injection treatment. The clinical effect is measurable, and a statistically significant improvement of the radicular pain is registered. Routine transforaminal injection treatment prior to surgery seems rewarding, but the complication risk must be taken into consideration.
F Kolstad; G Leivseth; O P Nygaard
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2005-06-09
Journal Detail:
Title:  Acta neurochirurgica     Volume:  147     ISSN:  0001-6268     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-23     Completed Date:  2006-09-29     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  1065-70; discussion 1070     Citation Subset:  IM    
National Centre of Spinal Disorders, Norwegian University of Science and Technology, University Hospital of Trondheim, Trondheim, Norway.
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MeSH Terms
Anti-Inflammatory Agents / administration & dosage*
Cervical Vertebrae / anatomy & histology,  surgery*
Cohort Studies
Glucocorticoids / administration & dosage*
Intervertebral Disk Displacement / complications,  physiopathology
Middle Aged
Neck Pain / drug therapy,  etiology,  physiopathology
Postoperative Complications / etiology,  physiopathology,  prevention & control
Prospective Studies
Radiculopathy / drug therapy*,  etiology,  physiopathology
Risk Assessment
Spinal Nerve Roots / drug effects*,  pathology,  physiopathology
Spinal Osteophytosis / complications,  physiopathology
Treatment Outcome
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Glucocorticoids

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