PM&R
Volume 1, Issue 2 , Pages 178-184 , February 2009

The Use of Epidural Corticosteroids for Cervical Radiculopathy: An Interlaminar Versus Transforaminal Approach

  • Matthew Smuck, MD (Guest Discussant)

      Affiliations

    • Department of Orthopaedic Surgery, Director, Stanford Interventional Spine Center Stanford University, Stanford, CA⁎
    • ,
  • Jack M. Rosenberg, MD (Guest Discussant)

      Affiliations

    • Departments of Physical Medicine and Rehabilitation and Anesthesiology, University of Michigan and Department of Veterans Affairs, Ann Arbor, MI⁎
    • ,
  • Venu Akuthota, MD (Senior Editor)

      Affiliations

    • Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, PO Box 6511, Mail Stop F-493, Aurora, CO 80045⁎
    • Corresponding Author InformationAddress correspondence to V.A.

References 

    Matthew Smuck, MD, Responds
  1. Saal JS, Saal JA, Yurth EF. Nonoperative management of herniated cervical intervertebral disc with radiculopathy. Spine. 1996;21:1877–1883
  2. Radhakrishnan K, Litchy WJ, O'Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy (A population-based study from Rochester, Minnesota, 1976 through 1990). Brain. 1994;117:325–335
  3. Bohlman HH, Emery SE, Goodfellow DB, Jones PK. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy (Long-term follow-up of one hundred and twenty-two patients). J Bone Joint Surg Am. 1993;75:1298–1307
  4. Gore DR, Sepic B. Anterior discectomy and fusion for painful cervical disc disease: a report of 50 patients with an average follow-up of 21 years. Spine. 1998;23:2047–2051
  5. Stav A, Ovadia L, Sternberg A, Kaadan M, Weksler N. Cervical epidural steroid injection for cervicobrachialgia. Acta Anaesthesiol Scand. 1993;37:562–566
  6. Haimovic IC, Beresford HR. Dexamethasone is not superior to placebo for treating lumbosacral radicular pain. Neurology. 1986;36:1593–1594
  7. Goel A, Pollan JJ. Contrast flow characteristics in the cervical epidural space: an analysis of cervical epidurograms. Spine. 2006;31:1576–1579
  8. Bush K, Hillier S. Outcome of cervical radiculopathy treated with periradicular/epidural corticosteroid injections: a prospective study with independent clinical review. Eur Spine J. 1996;5:319–325
  9. Vallee JN, Feydy A, Carlier RY, Mutschler C, Mompoint D, Vallee CA. Chronic cervical radiculopathy: lateral approach periradicular corticosteroid injection. Radiology. 2001;218:886–892
  10. Derby R, Lee SH, Kim BJ, Chen Y, Seo KS. Complications following cervical epidural steroid injections by expert interventionalists in 2003. Pain Physician. 2004;7:445–449
  11. Ma DJ, Gilula LA, Riew KD. Complications of fluoroscopically guided extraforaminal cervical nerve blocks (An analysis of 1036 injections). J Bone Joint Surg Am. 2005;87:1025–1030
    Jack Rosenberg, MD, Responds
  1. Olivero WC, Dulebohn SC. Results of halter traction for treatment of cervical radiculopathy: Retrospective review of 81 patients. Neurosurg Focus. 2002;12:1–4
  2. Stav A, Ovadia L, Sternberg A, Kaadan M, Weksler N. Cervical epidural steroid injection for cervicobrachialgia. Acta Anaesthesiol Scand. 1993;37:562–566
  3. Scanlon GC, Moeller-Bertram T, Romanowsky SM, Wallace MS. Cervical transforaminal epidural steroid injections: more dangerous than we think?. Spine. 2007;32:1249–1256
  4. Jasper JF. Role of digital subtraction fluoroscopic imaging in detecting intravascular injections. Pain Physician. 2003;6:369–372
    Dr. Smuck's Rebuttal
  1. Saal JS, Saal JA, Yurth EF. Nonoperative management of herniated cervical intervertebral disc with radiculopathy. Spine. 1996;21:1877–1883
  2. Bush K, Hillier S. Outcome of cervical radiculopathy treated with periradicular/epidural corticosteroid injections: A prospective study with independent clinical review. Eur Spine J. 1996;5:319–325
  3. Bush K, Chaudhuri R, Hillier S, Penny J. The pathomorphologic changes that accompany the resolution of cervical radiculopathy (A prospective study with repeat magnetic resonance imaging). Spine. 1997;22:183–186
  4. Maigne JY, Deligne L. Computed tomographic follow-up study of 21 cases of nonoperatively treated cervical intervertebral soft disc herniation. Spine. 1994;19:189–191
  5. Matsumoto M, Fujimura Y, Suzuki N, Nishi Y, Nakamura M, Yabe Y, et al. MRI of cervical intervertebral discs in asymptomatic subjects. J Bone Joint Surg Br. 1998;80:19–24
  6. Hagen KB, Jamtvedt G, Hilde G, Winnem MF. The updated cochrane review of bed rest for low back pain and sciatica. Spine. 2005;30:542–546
  7. Rainville J, Pransky G, Indahl A, Mayer EK. The physician as disability advisor for patients with musculoskeletal complaints. Spine. 2005;30:2579–2584
  8. Landers MR, Creger RV, Baker CV, Stutelberg KS. The use of fear-avoidance beliefs and nonorganic signs in predicting prolonged disability in patients with neck pain. Man Ther. 2008;13:239–248
  9. Swinkels-Meewisse IE, Roelofs J, Schouten EG, Verbeek AL, Oostendorp RA, Vlaeyen JW. Fear of movement/(re)injury predicting chronic disabling low back pain: A prospective inception cohort study. Spine. 2006;31:658–664
  10. Fredman B, Nun MB, Zohar E, et al. Epidural corticosteroids for treating “failed back surgery syndrome”: Is fluoroscopy really necessary?. Anesth Analg. 1999;88:367–372
  11. Schaufele MK, Hatch L, Jones W. Interlaminar versus transforaminal epidural injections for the treatment of symptomatic lumbar intervertebral disc herniations. Pain Physician. 2006;9:361–366
  12. Thomas E, Cyteval C, Abiad L, Picot MC, Taorel P, Blotman F. Efficacy of transforaminal versus interspinous corticosteroids injection in discal radiculalgia—a prospective, randomized, double-blind study. Clin Rheumatol. 2003;22:299–304
  13. Stav A, Ovadia L, Sternberg A, Kaadan M, Weksler N. Cervical epidural steroid injection for cervicobrachialgia. Acta Anaesthesiol Scand. 1993;37:562–566
  14. Derby R, Lee SH, Kim BJ, Chen Y, Seo KS. Complications following cervical epidural steroid injections by expert interventionalists in 2003. Pain Physician. 2004;7:445–449
  15. Williams KN, Jackowski A, Evans PJ. Epidural haematoma requiring surgical decompression following repeated cervical epidural steroid injections for chronic pain. Pain. 1990;42:197–199
  16. Huang RC, Shapiro GS, Lim M, Sandhu HS, Lutz GE, Herzog RJ. Cervical epidural abscess after epidural steroid injection. Spine. 2004;29:E7–E9
  17. Bose B. Quadriparesis following cervical epidural steroid injections: Case report and review of the literature. Spine J. 2005;5:558–563
  18. Reitman CA, Watters W. Subdural hematoma after cervical epidural steroid injection. Spine. 2002;27:E174–E176
  19. Ma DJ, Gilula LA, Riew KD. Complications of fluoroscopically guided extraforaminal cervical nerve blocks (An analysis of 1036 injections). J Bone Joint Surg Am. 2005;87:1025–1030
  20. Scanlon GC, Moeller-Bertram T, Romanowsky SM, Wallace MS. Cervical transforaminal epidural steroid injections: more dangerous than we think?. Spine. 2007;32:1249–1256
  21. Tiso RL, Cutler T, Catania JA, Whalen K. Adverse central nervous system sequelae after selective transforaminal block: The role of corticosteroids. Spine J. 2004;4:468–474
  22. Furman MB, Giovanniello MT, O'Brien EM. Incidence of intravascular penetration in transforaminal cervical epidural steroid injections. Spine. 2003;28:21–25
  23. Smuck M, Fuller B, Chiodo A, et al. Accuracy of intermittent fluoroscopy to detect intravascular injection during transforaminal epidural injections. Spine. 2008;33:E205–E210
  24. Okubadejo GO, Talcott MR, Schmidt RE, Sharma A, Patel AA, Mackey RB, et al. Perils of intravascular methylprednisolone injection into the vertebral artery (An animal study). J Bone Joint Surg Am. 2008;90:1932–1938
  25. Dreyfuss P, Baker R, Bogduk N. Comparative effectiveness of cervical transforaminal injections with particulate and nonparticulate corticosteroid preparations for cervical radicular pain. Pain Med. 2006;7:237–242
    Dr. Rosenberg's Rebuttal
  1. Haines T, Gross A, Goldsmith CH, Perry L. Patient education for neck pain with or without radiculopathy. Cochrane Database of Systematic Reviews. 2008;Issue 4. Art. No.: CD005106. DOI: 10.1002/14651858.CD005106.pub2
  2. Gillett GR. Innovative treatments: ethical requirements for evaluation. J Clin Neurosci. 1998;5:378–381

PII: S1934-1482(08)00040-3

doi: 10.1016/j.pmrj.2008.12.001

PM&R
Volume 1, Issue 2 , Pages 178-184 , February 2009

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