Abstract | BACKGROUND: Chronic neck pain is a common problem in the adult population with a typical 12-month prevalence of 30% to 50%. Cervical disc herniation and radiculitis is one of the common conditions described responsible for chronic neck and upper extremity pain. Cervical epidural injections for managing chronic neck pain with disc herniation are one of the commonly performed non-surgical interventions in the United States. However, the literature supporting cervical interlaminar epidural steroids in managing chronic neck pain is scant. STUDY DESIGN: A randomized, double-blind, controlled trial. SETTING: A private interventional pain management practice and specialty referral center in the United States. OBJECTIVES: METHODS: OUTCOMES ASSESSMENT: Multiple outcome measures were utilized. They included the Numeric Rating Scale (NRS), the Neck Disability Index (NDI), employment status, and opioid intake. Assessments were done at baseline and 3, 6, and 12 months post-treatment. Significant pain relief was defined as 50% or more; significant improvement in disability score was defined as a reduction of 50% or more. RESULTS: Significant pain relief (> or = 50%) was demonstrated in 77% of patients in both groups. Functional status improvement was demonstrated by a reduction (> or = 50%) in the NDI scores in 74% of Group I and 71% of Group II at 12 months. The overall average procedures per year were 3.7 +/- 1.1 in Group I and 4.0 +/- 0.91 in Group II; the average total relief per year was 39.45 +/- 11.59 weeks in Group I and 41.06 +/- 11.56 weeks in Group II over the 52 week study period in the patients defined as successful. The initial therapy was considered to be successful if a patient obtained consistent relief with 2 initial injections lasting at least 4 weeks. All others were considered failures. LIMITATIONS: The study results are limited by the lack of a placebo group and a preliminary report of 70 patients, 35 in each group. CONCLUSION:
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Authors | Laxmaiah Manchikanti, Kimberly A Cash, Vidyasagar Pampati, Bradley W Wargo, Yogesh Malla |
Journal | Pain physician
(Pain Physician)
2010 May-Jun
Vol. 13
Issue 3
Pg. 223-36
ISSN: 2150-1149 [Electronic] United States |
PMID | 20495586
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Analgesics, Opioid
- Anesthetics, Local
- Lidocaine
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Topics |
- Adult
- Analgesics, Opioid
(administration & dosage)
- Anesthetics, Local
(administration & dosage)
- Cervical Vertebrae
- Chronic Disease
- Double-Blind Method
- Female
- Fluoroscopy
- Humans
- Injections, Epidural
(adverse effects)
- Intervertebral Disc Displacement
(drug therapy)
- Lidocaine
(administration & dosage)
- Male
- Middle Aged
- Palliative Care
- Radiculopathy
(drug therapy)
- Treatment Outcome
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