Abstract | STUDY DESIGN: A randomized, double-blind, active-controlled trial. OBJECTIVE: SUMMARY OF BACKGROUND DATA: METHODS: One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain as determined by means of controlled diagnostic medial branch blocks were randomly assigned to one of the 2 treatment groups. Group I patients received cervical interlaminar epidural injections of local anesthetic ( lidocaine 0.5%, 5 mL), whereas Group II patients received 0.5% lidocaine, 4 mL, mixed with 1 mL or 6 mg of nonparticulate betamethasone. The primary outcome measure was ≥ 50% improvement in pain and function. Outcome assessments included numeric rating scale (NRS), Neck Disability Index (NDI), opioid intake, employment, and changes in weight. RESULTS: Significant pain relief and functional improvement (≥ 50%) was present at the end of 2 years in 73% of patients receiving local anesthetic only and 70% receiving local anesthetic with steroids. In the successful group of patients, however, defined as consistent relief with 2 initial injections of at least 3 weeks, significant improvement was illustrated in 78% in the local anesthetic group and 75% in the local anesthetic with steroid group at the end of 2 years. The results reported at the one-year follow-up were sustained at the 2-year follow-up. CONCLUSIONS: Cervical interlaminar epidural injections with or without steroids may provide significant improvement in pain and functioning in patients with chronic discogenic or axial pain that is function-limiting and not related to facet joint pain.
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Authors | Laxmaiah Manchikanti, Kimberly A Cash, Vidyasagar Pampati, Yogesh Malla |
Journal | International journal of medical sciences
(Int J Med Sci)
Vol. 11
Issue 4
Pg. 309-20
( 2014)
ISSN: 1449-1907 [Electronic] Australia |
PMID | 24578607
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Anesthetics, Local
- Lidocaine
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Topics |
- Adult
- Anesthetics, Local
(administration & dosage, therapeutic use)
- Double-Blind Method
- Female
- Humans
- Injections, Epidural
- Lidocaine
(administration & dosage, therapeutic use)
- Male
- Middle Aged
- Neck Pain
(drug therapy)
- Treatment Outcome
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