| Is chronic opioid use a negative predictive factor for response to cervical epidural steroid injections? | |
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MedLine Citation:
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PMID: 21849725 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background: Cervical epidural steroid injections (ESIs) are often used to treat patients with neck and upper extremity pain associated with a cervical radiculopathy. The effect of chronic opioid use in cervical radiculopathy patients managed with ESIs is unknown; past studies suggest that these patients may behave differently than opioid naïve patients. The purpose of this study is to determine the effect of chronic (greater than 6 months) opioid use on the immediate outcome of cervical ESIs. Methods: A two year retrospective chart review identified 22 consecutive patients with cervical radiculopathy who underwent a single level interlaminar cervical ESI, main outcome variable was > 50% pain relief on VAS at follow up. Inclusion factors were unilateral disc protrusion, exclusion factors were severe central canal or foraminal stenosis, spondylolithesis, spinal instability, cord edema, or with multi-level disc protrusions. Results: Using a linear logistic regression analysis on both patient demographics and physical exam measures, the most significant explanatory model was the use of opiates at the time of injection; 70% of opioid naïve patients had a favorable outcome while only 20% of patients managed with chronic opioids had relief (p= 0.06). Conclusions: Patients managed with opioids chronically may respond in a different manner to ESIs when compared to opioid naïve patients. |
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Authors:
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Dhiruj Kirpalani; Raj Mitra |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of back and musculoskeletal rehabilitation Volume: 24 ISSN: 1878-6324 ISO Abbreviation: J Back Musculoskelet Rehabil Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-08-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9201340 Medline TA: J Back Musculoskelet Rehabil Country: Netherlands |
Other Details:
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Languages: eng Pagination: 123-7 Citation Subset: IM |
Affiliation:
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Kaiser Permanente Santa Clara Medical Center, Department of Physical Medicine and Rehabilitation, Santa Clara, CA, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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