One-year results from a randomized comparative trial of targeted steroid injection via epidural catheter versus standard transforaminal epidural injection for the treatment of unilateral cervical radicular pain
| Autor: | Erica F Bisson, Zachary L McCormick, Russell Petersen, Aaron Conger, Fabio Salazar, A. Michael Henrie, Richard Kendall, Shellie Cunningham, Masaru Teramoto, Beau P. Sperry |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Steroid injection Triamcinolone acetonide Catheters medicine.medical_treatment Injections Epidural Pain Refractory medicine Humans Prospective Studies Radiculopathy Dexamethasone business.industry Epidural steroid injection General Medicine Middle Aged medicine.disease Surgery Catheter Anesthesiology and Pain Medicine Treatment Outcome Radicular pain Female Steroids business Body mass index medicine.drug |
| Zdroj: | Regional anesthesia and pain medicine. 46(9) |
| ISSN: | 1532-8651 |
| Popis: | ObjectivesThe objective of this study was to evaluate the long-term effectiveness of catheter-directed cervical interlaminar epidural steroid injection with triamcinolone compared with cervical transforaminal steroid injection with dexamethasone for the treatment of refractory unilateral radicular pain.DesignProspective, randomized, comparative trial.MethodsThe primary outcome was the proportion of participants with ≥50% Numeric Rating Scale ‘dominant pain’ (the greater of arm vs neck) reduction from baseline. Secondary outcomes included ≥30% Neck Disability Index reduction and Patient Global Impression of Change response indicating ‘much improved’ or ‘very much improved’.ResultsData from 117 participants (55.6% women; 52.3±12.5 years of age; body mass index, 28.2±6.5 kg/m2) were analyzed. The proportion of participants who experienced ≥50% pain reduction at 1 month, 3 months, and 6 months has been previously reported. At 1 year, 61.2% (95% CI, 46.9% to 73.9%) of the catheter group compared with 51.9% (95% CI, 38.4% to 65.2%) of the transforaminal group reported ≥50% ‘dominant’ pain reduction (p=0.35). The proportion of participants who experienced ≥30% improvement in Neck Disability Index score was 60.4% (95% CI, 45.9% to 73.3%) and 47.1% (95% CI, 33.7% to 60.8%) in the catheter and transforaminal groups (p=0.18). Patient Global Impression of Change improvement was similar in both groups: 60.5% (95% CI, 44.2% to 74.8%) and 57.5% (95% CI, 41.7% to 71.9%) of the catheter and transforaminal groups reported being ‘much improved’ or ‘very much improved’, respectively (p=0.79).ConclusionBoth cervical catheter-directed interlaminar epidural injection and cervical transforaminal steroid injection were effective in reducing pain and disability in the majority of participants with refractory unilateral cervical radiculopathy for up to 1 year. |
| Databáze: | OpenAIRE |
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