Efficacity of CT-guided intra-articular cervical facet steroid injection for cervical radiculopathy

Clément Ravenel , Charlotte Martin-Peltier , Maxime Lacroix , Fadila Mihoubi-Bouvier , Christelle Nguyen , Romain Touzé , Jean-Luc Drapé
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Abstract

Background

Traditionally, transforaminal steroid injection is performed in the management of cervical radiculopathy in medical failure treatment but carried a true risk of catastrophic complication. Another approach currently used is to perform intra-articular facet steroid injection to reach the epidural space.

Purpose

The aim of this study was to describe the evolution of symptoms following intra-articular facet steroid injection in cervical radiculopathy.

Material and methods

We conducted a retrospective study. We assessed all patients who had a CT-guided intra-articular facet steroid injection in our center (xx, xx, xx) from December 2015 to February 2021. Cervical MR pretherapeutic images were analyzed and classified according to cervical pain etiology: uncodiscarthrosis, disk herniation or congestive cervical posterior osteo-arthritis. All patients had clinical initial evaluation and then follow-up at 1 and 6 months. Pain severity was rated on a visual analog scale and expressed as a percentage of improvement.

Results

Ninety-three patients were included. There were 56 patients with uncodiscarthrosis, 29 with a disk herniation and 8 with a cervical posterior congestive osteoarthritis. A significant improvement of the visual analog scale percentage was found for all patient at 1 and 6 months (p < 0.01). Visual analog scale percentage improvement was about 50 % for all etiologies. For all patients, no severe complications were reported.

Conclusion

Intra-articular facet steroid injection may be considered for the treatment of cervical radiculopathy when other medical treatments have failed.

CT 引导下颈椎关节内注射类固醇治疗颈椎病的疗效
背景传统上,经椎间孔注射类固醇是在医疗失败的颈椎病治疗中进行的,但确实存在发生灾难性并发症的风险。目前使用的另一种方法是进行关节面内侧类固醇注射,以到达硬膜外腔。我们对 2015 年 12 月至 2021 年 2 月期间在本中心(xx、xx、xx)进行 CT 引导下关节内注射类固醇的所有患者进行了评估。对治疗前的颈椎 MR 图像进行分析,并根据颈椎疼痛病因进行分类:非椎间盘突出症、椎间盘突出症或充血性颈椎后路骨关节炎。所有患者都进行了临床初步评估,然后在 1 个月和 6 个月时进行随访。疼痛严重程度用视觉模拟量表评分,并以改善百分比表示。其中,56 名患者患有非椎间盘突出症,29 名患者患有椎间盘突出症,8 名患者患有颈椎后方充血性骨关节炎。所有患者的视觉模拟量表百分比在 1 个月和 6 个月后均有明显改善(p < 0.01)。在所有病因中,视觉模拟量表的改善率约为 50%。结论当其他药物治疗无效时,可考虑采用关节面注射类固醇来治疗颈椎病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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