Andrew R. Stephens, Ramzi El-Hassan, Ben L. Laplante, Rajeev K. Patel
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Patient Reported Outcome Measurement Information System (PROMIS) domains of Physical Function (PF) v1.2/v2.0 and Pain Interference (PI) v1.1 were collected at baseline and at 3-, 6-, and 12-month follow-up visits. Statistical analysis comparing baseline score with follow-up post-procedural PROMIS scores was performed. The percentage of patients who reported improvement exceeding the minimal clinically important difference was calculated for survey responders and for the worst case scenario.</div></div><div><h3>Results</h3><div>87 patients met inclusion criteria. PROMIS PI at 3-, 6-, and 12-months follow-up statistically improved by 2.2 (95 % confidence interval [CI] 2.1–2.4, p = 0.02), 2.3 (95 % CI 2.1–2.5, p = 0.03), and 2.7 (95 % CI 2.5–3.0, p = 0.03) points, respectively. Follow-up PROMIS PF score did not significantly differ from baseline scores. The percentage of patients that exceeded MCID thresholds of clinical significance was 59 % (95 % CI 47%–70 %) at 3-months, 52 % (95 % CI 41%–63 %) at 6-months, and 60 % (95 % CI 50%–72 %) at 12-months. Worst case scenario analysis demonstrated that 51 % (95 % CI 39%–62 %) of patients exceeded the MCID thresholds at 3-months, 32 % (95 % CI 22%–43 %) at 6-months, and 23 % (95 % CI 13%–33 %) at 12-months.</div></div><div><h3>Conclusions</h3><div>Our study demonstrated that TFESI leads to a long-term improvement up to a year in pain for patients with cervical radiculopathy.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"4 1","pages":"Article 100556"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of fluoroscopically guided transforaminal epidural steroid injections for cervical radiculopathy utilizing patient reported outcome measurement information system as an outcome measure\",\"authors\":\"Andrew R. Stephens, Ramzi El-Hassan, Ben L. Laplante, Rajeev K. 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Patient Reported Outcome Measurement Information System (PROMIS) domains of Physical Function (PF) v1.2/v2.0 and Pain Interference (PI) v1.1 were collected at baseline and at 3-, 6-, and 12-month follow-up visits. Statistical analysis comparing baseline score with follow-up post-procedural PROMIS scores was performed. The percentage of patients who reported improvement exceeding the minimal clinically important difference was calculated for survey responders and for the worst case scenario.</div></div><div><h3>Results</h3><div>87 patients met inclusion criteria. PROMIS PI at 3-, 6-, and 12-months follow-up statistically improved by 2.2 (95 % confidence interval [CI] 2.1–2.4, p = 0.02), 2.3 (95 % CI 2.1–2.5, p = 0.03), and 2.7 (95 % CI 2.5–3.0, p = 0.03) points, respectively. Follow-up PROMIS PF score did not significantly differ from baseline scores. 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引用次数: 0
摘要
背景：颈神经根病是疼痛的常见原因。对于保守治疗失败的患者，经椎间孔硬膜外类固醇注射（TFESI）是一种公认的干预措施，可替代减压手术。目的评价tfis对颈椎病患者的治疗效果。方法：在一个多学科的三级学术脊柱中心接受治疗的成人患者，有颈椎神经根疼痛和MRI确证的颈椎病椎间孔狭窄，并且包括药物和物理康复在内的保守治疗至少6周失败。在基线和3个月、6个月和12个月的随访中收集患者报告结果测量信息系统（PROMIS）身体功能（PF） v1.2/v2.0和疼痛干扰（PI） v1.1域。对基线评分与随访术后PROMIS评分进行统计分析。报告改善超过最小临床重要差异的患者百分比是根据调查应答者和最坏情况计算的。结果87例患者符合纳入标准。随访3、6、12个月时PROMIS PI分别提高2.2点（95%可信区间[CI] 2.1 ~ 2.4, p = 0.02）、2.3点（95% CI 2.1 ~ 2.5, p = 0.03）、2.7点（95% CI 2.5 ~ 3.0, p = 0.03）。随访PROMIS PF评分与基线评分无显著差异。超过MCID临床意义阈值的患者百分比在3个月时为59% (95% CI 47% - 70%)， 6个月时为52% (95% CI 41% - 63%)， 12个月时为60% （95% CI 50% - 72%）。最坏情况分析表明，51% （95% CI 39% - 62%）的患者在3个月时超过了MCID阈值，32% （95% CI 22% - 43%）的患者在6个月时超过了阈值，23% （95% CI 13% - 33%）的患者在12个月时超过了阈值。结论：我们的研究表明，TFESI可以长期改善颈神经根病患者长达一年的疼痛。
Evaluation of fluoroscopically guided transforaminal epidural steroid injections for cervical radiculopathy utilizing patient reported outcome measurement information system as an outcome measure
Background
Cervical radiculopathy is a common cause of pain. For patients who fail conservative management, a transforaminal epidural steroid injection (TFESI) is an accepted intervention and alternative to decompression surgery.
Objective
The purpose of this study was to evaluate the therapeutic effect of TFESIs for patients with cervical radiculopathy.
Methods
Adult patients treated at a multidisciplinary, tertiary academic spine center with cervical radicular pain and MRI evidence of corroborative cervical spondylotic foraminal stenosis and who had failed at least 6 weeks of conservative management consisting of medication and physical rehabilitation were included in this study. Patient Reported Outcome Measurement Information System (PROMIS) domains of Physical Function (PF) v1.2/v2.0 and Pain Interference (PI) v1.1 were collected at baseline and at 3-, 6-, and 12-month follow-up visits. Statistical analysis comparing baseline score with follow-up post-procedural PROMIS scores was performed. The percentage of patients who reported improvement exceeding the minimal clinically important difference was calculated for survey responders and for the worst case scenario.
Results
87 patients met inclusion criteria. PROMIS PI at 3-, 6-, and 12-months follow-up statistically improved by 2.2 (95 % confidence interval [CI] 2.1–2.4, p = 0.02), 2.3 (95 % CI 2.1–2.5, p = 0.03), and 2.7 (95 % CI 2.5–3.0, p = 0.03) points, respectively. Follow-up PROMIS PF score did not significantly differ from baseline scores. The percentage of patients that exceeded MCID thresholds of clinical significance was 59 % (95 % CI 47%–70 %) at 3-months, 52 % (95 % CI 41%–63 %) at 6-months, and 60 % (95 % CI 50%–72 %) at 12-months. Worst case scenario analysis demonstrated that 51 % (95 % CI 39%–62 %) of patients exceeded the MCID thresholds at 3-months, 32 % (95 % CI 22%–43 %) at 6-months, and 23 % (95 % CI 13%–33 %) at 12-months.
Conclusions
Our study demonstrated that TFESI leads to a long-term improvement up to a year in pain for patients with cervical radiculopathy.
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