Translaminar cervical epidural steroid injection: short-term results and factors influencing outcome

Abstract

Purpose: To assess the efficacy of translaminar cervical epidural steroid injection (ESI) in the management of localized or radicular neck pain and assess categoric factors that can help predict clinical outcome.

Materials and methods: In all patients studied, treatment of neck pain with oral pain medications or physical therapy had failed. A total of 280 translaminar cervical ESIs were performed in 161 patients with an average age of 58 years (range, 26-82 y). The average duration of symptoms until the time the procedure was performed was 18.2 months (range, 0.25-240 months). All patients were assessed by telephone approximately 10 days after the procedure to determine efficacy.

Results: Of the 280 total injections, 233 (83%) resulted in pain relief. Patients were more likely to experience pain relief if they presented with multilevel degenerative changes (odds ratio [OR] = 4.13, P = .0055), had radicular symptoms in the hand and/or finger (OR = 2.72, P = .0011), or underwent injection at the C7-T1 level (OR = 2.44, P = .0034). Patients who required narcotics for their symptoms before the procedure showed lower odds of pain relief (OR = 0.80, P = .4367). There were no major complications and the overall minor complication rate was 5.18%.

Conclusion: Translaminar cervical ESI is a safe procedure. Although repeat injections may be necessary in some patients, excellent short-term clinical results can be achieved.