Optimizing Cervical Epidural Steroid Injections: A Case Report.

Abstract

Cervical radiculopathy is characterized by pain, numbness, and weakness in the upper limbs. This is typically caused by nerve root compression. While conservative treatments like physical therapy and oral analgesics are often used, they may not be effective in more severe cases. Cervical epidural steroid injections (CESIs), particularly through the interlaminar approach, may be considered when these initial treatments fail. This case report discusses a female patient with severe left upper extremity pain consistent with C5/6 and C6/7 radiculopathy who did not respond to conservative therapies. An interlaminar CESI was initially performed at the C7/T1 level, but the contrast flow was inadequate for effective drug delivery. Repositioning the needle at the C6/C7 interspace improved contrast distribution, successfully targeting the affected levels. The patient experienced a 90% reduction in symptoms three weeks after the procedure, underscoring the importance of accurate contrast flow assessment and needle placement in CESIs. This case highlights the effectiveness of CESI in treating cervical radiculopathy and the critical role of precise technique in achieving positive patient outcomes.