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The effectiveness of ultrasound-guided cervical transforaminal epidural steroid injections in cervical radiculopathy: a prospective pilot study

BACKGROUND: Cervical transforaminal epidural steroid injection (CTFESI) is used to provide pain relief and restore function in patients with cervical radiculopathy. Traditionally, it is performed under the guidance of fluoroscopy or computed tomography. Here, we introduce a novel technique – ultraso...

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Autores principales: Zhang, Xin, Shi, Haifeng, Zhou, Jin, Xu, Yongming, Pu, Shaofeng, Lv, Yingying, Wu, Junzhen, Cheng, Yueping, Du, Dongping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318715/
https://www.ncbi.nlm.nih.gov/pubmed/30643449
http://dx.doi.org/10.2147/JPR.S181915
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author Zhang, Xin
Shi, Haifeng
Zhou, Jin
Xu, Yongming
Pu, Shaofeng
Lv, Yingying
Wu, Junzhen
Cheng, Yueping
Du, Dongping
author_facet Zhang, Xin
Shi, Haifeng
Zhou, Jin
Xu, Yongming
Pu, Shaofeng
Lv, Yingying
Wu, Junzhen
Cheng, Yueping
Du, Dongping
author_sort Zhang, Xin
collection PubMed
description BACKGROUND: Cervical transforaminal epidural steroid injection (CTFESI) is used to provide pain relief and restore function in patients with cervical radiculopathy. Traditionally, it is performed under the guidance of fluoroscopy or computed tomography. Here, we introduce a novel technique – ultrasound-guided CTFESI – with which operators can easily distinguish the close soft tissue (nerve, vessels) around the cervical foramina to avoid intravascular injection during the procedure. OBJECTIVE: To present the immediate and long-term effectiveness of ultrasound-guided CTFESI in patients with cervical radiculopathy in an academic pain-management center with prospective clinic experiments. METHODS: Fifteen patients with cervical radiculopathy who were resistant to conservative therapies and ultrasound-guided selective cervical spinal nerve-root injections, were treated with ultrasound-guided CTFESI. During the injection procedures, the needle tips were reconfirmed by real-time fluoroscopy. Pain numeric rating-scale and neck-disability-index scores were assessed from onset to six months after the procedures. RESULTS: During the procedures, based on real-time fluoroscopic confirmation, the injection solution outlined the spinal nerve root and spread into the epidural space in most cases (14 of 15). All patients reported pain relief within 10 minutes after the injection. The majority of patients (eleven of 15) experienced pain relief and neck-disability index-score improvement throughout the 6-month study period. No patient experienced any complication. CONCLUSION: We suggest that ultrasound-guided CTFESI is an effective, safe, and simple procedure free of radiation or magnetization and provides sustained pain relief in patients with cervical radiculopathy who have failed previous conservation therapies.
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spelling pubmed-63187152019-01-14 The effectiveness of ultrasound-guided cervical transforaminal epidural steroid injections in cervical radiculopathy: a prospective pilot study Zhang, Xin Shi, Haifeng Zhou, Jin Xu, Yongming Pu, Shaofeng Lv, Yingying Wu, Junzhen Cheng, Yueping Du, Dongping J Pain Res Case Series BACKGROUND: Cervical transforaminal epidural steroid injection (CTFESI) is used to provide pain relief and restore function in patients with cervical radiculopathy. Traditionally, it is performed under the guidance of fluoroscopy or computed tomography. Here, we introduce a novel technique – ultrasound-guided CTFESI – with which operators can easily distinguish the close soft tissue (nerve, vessels) around the cervical foramina to avoid intravascular injection during the procedure. OBJECTIVE: To present the immediate and long-term effectiveness of ultrasound-guided CTFESI in patients with cervical radiculopathy in an academic pain-management center with prospective clinic experiments. METHODS: Fifteen patients with cervical radiculopathy who were resistant to conservative therapies and ultrasound-guided selective cervical spinal nerve-root injections, were treated with ultrasound-guided CTFESI. During the injection procedures, the needle tips were reconfirmed by real-time fluoroscopy. Pain numeric rating-scale and neck-disability-index scores were assessed from onset to six months after the procedures. RESULTS: During the procedures, based on real-time fluoroscopic confirmation, the injection solution outlined the spinal nerve root and spread into the epidural space in most cases (14 of 15). All patients reported pain relief within 10 minutes after the injection. The majority of patients (eleven of 15) experienced pain relief and neck-disability index-score improvement throughout the 6-month study period. No patient experienced any complication. CONCLUSION: We suggest that ultrasound-guided CTFESI is an effective, safe, and simple procedure free of radiation or magnetization and provides sustained pain relief in patients with cervical radiculopathy who have failed previous conservation therapies. Dove Medical Press 2018-12-31 /pmc/articles/PMC6318715/ /pubmed/30643449 http://dx.doi.org/10.2147/JPR.S181915 Text en © 2019 Zhang et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Case Series
Zhang, Xin
Shi, Haifeng
Zhou, Jin
Xu, Yongming
Pu, Shaofeng
Lv, Yingying
Wu, Junzhen
Cheng, Yueping
Du, Dongping
The effectiveness of ultrasound-guided cervical transforaminal epidural steroid injections in cervical radiculopathy: a prospective pilot study
title The effectiveness of ultrasound-guided cervical transforaminal epidural steroid injections in cervical radiculopathy: a prospective pilot study
title_full The effectiveness of ultrasound-guided cervical transforaminal epidural steroid injections in cervical radiculopathy: a prospective pilot study
title_fullStr The effectiveness of ultrasound-guided cervical transforaminal epidural steroid injections in cervical radiculopathy: a prospective pilot study
title_full_unstemmed The effectiveness of ultrasound-guided cervical transforaminal epidural steroid injections in cervical radiculopathy: a prospective pilot study
title_short The effectiveness of ultrasound-guided cervical transforaminal epidural steroid injections in cervical radiculopathy: a prospective pilot study
title_sort effectiveness of ultrasound-guided cervical transforaminal epidural steroid injections in cervical radiculopathy: a prospective pilot study
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318715/
https://www.ncbi.nlm.nih.gov/pubmed/30643449
http://dx.doi.org/10.2147/JPR.S181915
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