Menu
Menu
19 Harley St, London, W1G 9QJ, UK

Fluoroscopic epidural injections in cervical spinal stenosis: preliminary results of a randomized, double-blind, active control trial

BACKGROUND: Cervical spinal stenosis is a common disease that results in considerable morbidity and disability. There are multiple modalities of treatments, including surgical interventions and multiple interventional techniques including epidural injections. The literature on the effectiveness of cervical epidural steroids is sporadic. Emerging evidence for cervical interlaminar epidurals for various conditions in the cervical spine is positive; however, the effect of fluoroscopic epidural injections in cervical spinal stenosis has not been studied. STUDY DESIGN: A randomized, double-blind, active control trial. SETTING: A private interventional pain management practice, a specialty referral center in the United States. OBJECTIVES: To evaluate the effectiveness of cervical interlaminar epidural injections with local anesthetic with or without steroids in the management of chronic neck pain with upper extremity pain in patients with cervical central spinal stenosis. METHODS: Patients with cervical central spinal stenosis were randomly assigned to one of 2 groups: injection of local anesthetic only or local anesthetic mixed with non-particulate betamethasone. Sixty patients were included in this analysis. Randomization was performed by computer-generated random allocation sequence by simple randomization. OUTCOMES ASSESSMENT: Multiple outcome measures were utilized including the Numeric Rating Scale (NRS), the Neck Disability Index (NDI), employment status, and opioid intake with assessment at 3, 6, and 12 months post-treatment. Significant pain relief or functional status was defined as a 50% or more reduction of NRS or NDI scores. RESULTS: Significant pain relief was seen in 73% in Group I and 70% in Group II, in Group II showing both significat pain releif and functional status improvements. Group I’s average relief per procedures was 11.3 +/- 5.8 weeks; for Group II it was 8.6 +/- 3.6 weeks, whereas after initial 2 procedures, average relief was 13.7 +/- 8.7 weeks in Group I, and 13.6 +/- 4.7 weeks in Group II. In the successful group, the average total relief in a one-year period was 42.2 +/- 14.7 weeks in Group I and 34.3 +/- 13.4 weeks in Group II, with 76% in Group I and 77% in Group II. LIMITATIONS: Study limitations include the lack of a placebo group and that this is a preliminary report of only 60 patients, 30 in each group. CONCLUSION: Patients who have chronic function-limiting pain that is secondary to cervical central stenosis might receive relief with cervical interlaminar epidurals of local anesthetic, whether with or without steroids. CLINICAL TRIAL: NCT01071369

Keywords : Adult,analysis,Anesthetics,Anesthetics,Local,Anti-Inflammatory Agents,Betamethasone,Cervical Vertebrae,complications,Double-Blind Method,drug therapy,Drug Therapy,Combination,Employment,etiology,Female,Fluoroscopy,Humans,Injections,Injections,Epidural,Lidocaine,Male,methods,Middle Aged,Morbidity,Neck,Neck Pain,Pain,Pain Management,Pain Measurement,Patients,Random Allocation,secondary,Severity of Illness Index,Spinal Stenosis,Spine,Steroids,therapeutic use,Treatment Outcome,United States,Upper Extremity,, Epidural,Injections,Cervical,Spinal, ibs groin pain symptoms

Date of Publication : 2012 Jan

Authors : Manchikanti L;Malla Y;Cash KA;McManus CD;Pampati V;

Organisation : Pain Management Center of Paducah, Paducah, KY, USA. drlm@thepainmd.com

Journal of Publication : Pain Physician

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/22270749

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Fluoroscopic epidural injections in cervical spinal stenosis preliminary results of a randomized, double-blind, active control trial | Fibromyalgia doctor uk

What our patients say ...

Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Anaesthetist

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810