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Transforaminal steroid injections for the treatment of cervical radiculopathy: a prospective and randomised study.

Anderberg, Leif LU ; Annertz, Mårten LU ; Persson, Liselott LU ; Brandt, Lennart LU and Säveland, Hans LU (2007) In European Spine Journal 16(3). p.321-328
Abstract
Steroid injections are often employed as an alternative treatment for radicular pain in patients with degenerative spinal disorders. Prospective randomised studies of the lumbar spine reveal contradictory results and non-randomised and most often retrospective studies of the cervical spine indicate pain reduction from steroid injections. No prospective randomised study on transforaminal steroid injections for the treatment of radicular pain in the cervical spine focusing on short-term results has been performed. Forty consecutive patients were employed for the study. The inclusion criteria were one-sided cervical radiculopathy with radicular distribution of arm pain distal to the elbow and corresponding significant degenerative pathology... (More)
Steroid injections are often employed as an alternative treatment for radicular pain in patients with degenerative spinal disorders. Prospective randomised studies of the lumbar spine reveal contradictory results and non-randomised and most often retrospective studies of the cervical spine indicate pain reduction from steroid injections. No prospective randomised study on transforaminal steroid injections for the treatment of radicular pain in the cervical spine focusing on short-term results has been performed. Forty consecutive patients were employed for the study. The inclusion criteria were one-sided cervical radiculopathy with radicular distribution of arm pain distal to the elbow and corresponding significant degenerative pathology of the cervical spine at one or two levels on the same side as the radicular pain and visualised by MRI. A transforaminal technique was used for all injections. A positive response to a diagnostic selective nerve root block at one or two nerve roots was mandatory for all patients. The patients were randomised for treatment with steroids/local anaesthetics or saline/local anaesthetic. Only the neuroradiologist performing the blocks was aware of the content of the injection; all other persons involved in the study were blinded. Follow up was made 3 weeks after the randomised treatment by a clinical investigation and with a questionnaire focusing on the subjective effects from the injections. At follow up, there were no differences in treatment results in the two patient groups. Statistical analysis of the results confirmed the lack of difference in treatment effect. Further studies have to be performed before excluding steroids in such treatment and for evaluating the influence of local anaesthetics on radiculopathy in transforaminal injections. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Spine Journal
volume
16
issue
3
pages
321 - 328
publisher
Springer
external identifiers
  • wos:000245078800003
  • scopus:33947321440
ISSN
0940-6719
DOI
10.1007/s00586-006-0142-8
language
English
LU publication?
yes
id
4a23121f-7620-463c-afa2-8250e3ee47aa (old id 159048)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16835737&dopt=Abstract
date added to LUP
2007-07-13 09:18:26
date last changed
2017-08-27 04:12:55
@article{4a23121f-7620-463c-afa2-8250e3ee47aa,
  abstract     = {Steroid injections are often employed as an alternative treatment for radicular pain in patients with degenerative spinal disorders. Prospective randomised studies of the lumbar spine reveal contradictory results and non-randomised and most often retrospective studies of the cervical spine indicate pain reduction from steroid injections. No prospective randomised study on transforaminal steroid injections for the treatment of radicular pain in the cervical spine focusing on short-term results has been performed. Forty consecutive patients were employed for the study. The inclusion criteria were one-sided cervical radiculopathy with radicular distribution of arm pain distal to the elbow and corresponding significant degenerative pathology of the cervical spine at one or two levels on the same side as the radicular pain and visualised by MRI. A transforaminal technique was used for all injections. A positive response to a diagnostic selective nerve root block at one or two nerve roots was mandatory for all patients. The patients were randomised for treatment with steroids/local anaesthetics or saline/local anaesthetic. Only the neuroradiologist performing the blocks was aware of the content of the injection; all other persons involved in the study were blinded. Follow up was made 3 weeks after the randomised treatment by a clinical investigation and with a questionnaire focusing on the subjective effects from the injections. At follow up, there were no differences in treatment results in the two patient groups. Statistical analysis of the results confirmed the lack of difference in treatment effect. Further studies have to be performed before excluding steroids in such treatment and for evaluating the influence of local anaesthetics on radiculopathy in transforaminal injections.},
  author       = {Anderberg, Leif and Annertz, Mårten and Persson, Liselott and Brandt, Lennart and Säveland, Hans},
  issn         = {0940-6719},
  language     = {eng},
  number       = {3},
  pages        = {321--328},
  publisher    = {Springer},
  series       = {European Spine Journal},
  title        = {Transforaminal steroid injections for the treatment of cervical radiculopathy: a prospective and randomised study.},
  url          = {http://dx.doi.org/10.1007/s00586-006-0142-8},
  volume       = {16},
  year         = {2007},
}