Cervical epidural steroid injections for the treatment of cervical spinal (Neck) pain

Current Pain and Headache Reports

Volumn 17, Issue 2, 2013, Pages

  Candido, Kenneth D ^a,b   Knezevic, Nebojsa 'Nick' ^a,b  

^a ADVOCATE ILLINOIS MASONIC MEDICAL CENTER   (United States)

^b UNIVERSITY OF ILLINOIS AT CHICAGO   (United States)

Author keywords

Cervical epidural steroid injections; Cervical radiculopathy; Interlaminar epidural steroid injection; Neck pain; Transforaminal epidural steroid injection

Indexed keywords

BETAMETHASONE ACETATE; BETAMETHASONE SODIUM PHOSPHATE; CONTRAST MEDIUM; CORTICOSTEROID; DEXAMETHASONE; DEXAMETHASONE SODIUM PHOSPHATE; LIDOCAINE; LOCAL ANESTHETIC AGENT; METHYLPREDNISOLONE ACETATE; NONPARTICULATE STEROID; NONSTEROID ANTIINFLAMMATORY AGENT; PARTICULATE CORTICOSTEROID; PARTICULATE STEROID; STEROID; TRIAMCINOLONE ACETONIDE; UNCLASSIFIED DRUG;

ARTERY DISSECTION; ARTERY PERFORATION; ARTICLE; BLOOD VESSEL OCCLUSION; BRAIN EDEMA; BRAIN STEM INFARCTION; CARDIOPULMONARY ARREST; CEREBROVASCULAR ACCIDENT; CERVICAL EPIDURAL STEROID INJECTION; CERVICAL INTERLAMINAR EPIDURAL STEROID INJECTION; CERVICAL TRANSFORAMINAL EPIDURAL STEROID INJECTION; CHEMOTHERAPY INDUCED NAUSEA AND VOMITING; COMPUTER ASSISTED DRUG THERAPY; CONSERVATIVE TREATMENT; DEATH; DIGITAL SUBTRACTION ANGIOGRAPHY; DIZZINESS; DRUG FATALITY; DRUG INDUCED HEADACHE; DRUG SAFETY; EPIDURAL HEMATOMA; FAINTNESS; FLUOROSCOPY; FLUSHING; HEADACHE; HUMAN; INFARCTION; INJECTION; INJECTION SITE BLEEDING; INJECTION SITE REACTION; INTERMETHOD COMPARISON; INTRACTABLE PAIN; LOW DRUG DOSE; NAUSEA AND VOMITING; NECK PAIN; NEEDLE; NERVE BLOCK; PARESTHESIA; PHYSIOTHERAPY; PNEUMOCEPHALUS; RADIATION EXPOSURE; RADICULAR PAIN; SELECTIVE CERVICAL NERVE ROOT BLOCK; SIDE EFFECT; SPINAL CORD INFARCTION; SPINAL CORD INJURY; SPINAL INFARCTION; THROMBOEMBOLISM; TONIC CLONIC SEIZURE; BLEEDING; BLOOD VESSEL; CERVICAL SPINE; EPIDURAL DRUG ADMINISTRATION; FEMALE; INJURY; MALE; METHODOLOGY; PATHOPHYSIOLOGY; RADIOGRAPHY; REVIEW;

ANESTHETICS, LOCAL; ANGIOGRAPHY, DIGITAL SUBTRACTION; BLOOD VESSELS; CERVICAL VERTEBRAE; CONTRAST MEDIA; FEMALE; FLUOROSCOPY; HEMORRHAGE; HUMANS; INJECTIONS, EPIDURAL; MALE; NECK PAIN; NERVE BLOCK; STEROIDS;

MLCS; MLOWN;

EID: 84872074531     PISSN: 15313433     EISSN: 15343081     Source Type: Journal    
DOI: 10.1007/s11916-012-0314-7     Document Type: Article

References (50)

1. Thierry-Mieg J. Cervical epidural injections of corticoids in hyperalgic cervico-brachial neuralgias. 1st cervical epidurographical pictures. Rev Rhum Mal Osteoartic. 1961;28:451-3.
2. Slipman CW, Lipetz JS, Jackson HB, Rogers DP, Vresilovic EJ. Therapeutic selective nerve root block in the nonsurgical treatment of a traumatic cervical spondylotic radicular pain: a retrospective analysis with independent clinical review. Arch Phys Med Rehabil. 2000;81:741-6. (Pubitemid 30349716)
3. •• Manchikanti L, Boswell MV, Singh V, et al. Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2009;12:699-802. A systematic literature review of different interventional techniques used in the treatment of chronic spinal pain, including the cervical (neck) pain.
4. Stout A. Epidural steroid injections for cervical radiculopathy. Phys Med Rehabil Clin N Am. 2011;22:149-59.
5. Kang JD, Georgescu HI, McIntyre-Larkin L, Stefanovic-Racic M, Evans CH. Herniated cervical intervertebral discs spontaneously produce matrix metalloproteinases, nitric oxide, interleukin-6, and prostaglandin E2. Spine. 1995;20:2373-8.
6. • Lee SH, Kim KT, Kim DH, Lee BJ, Son ES, Kwack YH. Clinical outcomes of cervical radiculopathy following epidural steroid injection: a prospective study with follow-up for more than 2 years. Spine. 2012;37:1041-7. Prospective clinical study analyzing the effects of CILESI and CTFESI in the treatment of cervical radiculopathy with long follow up (more than 2 years).
7. Rathmell JP, Aprill C, Bogduk N. Cervical transforaminal injection of steroids. Anesthesiology. 2004;100:1595-600. (Pubitemid 38679331)
8. Tiso RL, Cutler T, Catania JA, Whalen K. Adverse central nervous system sequelae after selective transforaminal block: the role of corticosteroids. Spine J. 2004;4:468-74. (Pubitemid 38986988)
9. Han KR, Kim C, Park SK, Kim JS. Distance to the adult cervical epidural space. Reg Anesth Pain Med. 2003;28:95-7. (Pubitemid 36397782)
10. • Botwin KP, Castellanos R, Rao S, et al. Complications of fluoroscopically guided interlaminar cervical epidural injections. Arch Phys Med Rehabil. 2003;84:627-33. Retrospective study assessing the incidence of complications of fluoroscopically-guided CILESIs. (Pubitemid 36554490)
11. Goodman B, Petalcorin JS, Mallempati S. Optimizing patient positioning and fluoroscopic imaging for the performance of cervical interlaminar epidural steroid injections. Pm R. 2010;2:783-6.
12. Lirk P, Kolbitsch C, Putz G, et al. Cervical and high thoracic ligamentum flavum frequently fails to fuse in the midline. Anesthesiology. 2003;99:1387-90. (Pubitemid 37475186)
13. Goel A, Pollan JJ. Contrast flow characteristics in the cervical epidural space: an analysis of cervical epidurograms. Spine. 2006;31:1576-9.
14. Wolter T, Knoeller S, Berlis A, Hader C. CT-guided cervical selective nerve root block with a dorsal approach. AJNR: Am J Neuroradiol. 2010;31:1831-6.
15. Wald JT, Maus TP, Geske JR, et al. Safety and efficacy of CT-guided transforaminal cervical epidural steroid injections using a posterior approach. AJNR Am J Neuroradiol. 2012;33:415-9.
16. Anderberg L, Annertz M, Brandt L, Saveland H. Selective diagnostic cervical nerve root block-correlation with clinical symptoms and MRI-pathology. Acta Neurochir. 2004;146:559-65. (Pubitemid 38788791)
17. Manchikanti L. The growth of interventional pain management in the new millennium: a critical analysis of utilization in the Medicare population. Pain Physician. 2004;7:465-82. (Pubitemid 39562105)
18. • Jee H, Lee JH, Kim J, Park KD, Lee WY, Park Y. Ultrasound-guided selective nerve root block vs fluoroscopy-guided transforaminal block for the treatment of radicular pain in the lower cervical spine: a randomized, blinded, controlled study. Skeletal Radiol. 2013;42:69-78. Prospective clinical study comparing short-term effect and advantages of ultrasound-guided SCNRBs and fluoroscopically-guided CTFESIs.
19. Siegenthaler A, Mlekusch S, Trelle S, Schliessbach J, Curatolo M, Eichenberger U. Accuracy of ultrasound-guided nerve blocks of the cervical zygapophysial joints. Anesthesiology. 2012;117:347-52.
20. Tofuku K, Koga H, Komiya S. Subdural spread of injected local anesthetic in a selective transforaminal cervical nerve root block: a case report. J Med Case Rep. 2012;6:142.
21. Galiano K, Obwegeser AA, Walch C, Schatzer R, Ploner F, Gruber H. Ultrasound-guided vs computed tomography-controlled facet joint injections in the lumbar spine: a prospective randomized clinical trial. Reg Anesth Pain Med. 2007;32:317-22. (Pubitemid 47285753)
22. Huston CW. Cervical epidural steroid injections in the management of cervical radiculitis: interlaminar vs transforaminal. A review. Curr Rev Musculoskelet Med. 2009;2:30-42.
23. Manchikanti L, Malla Y, Wargo BW, Cash KA, Pampati V, Fellows B. Complications of fluoroscopically directed facet joint nerve blocks: a prospective evaluation of 7500 episodes with 43,000 nerve blocks. Pain Physician. 2012;15:E143-50.
24. Muro K, O'Shaughnessy B, Ganju A. Infarction of the cervical spinal cord following multilevel transforaminal epidural steroid injection: case report and review of the literature. J Spinal Cord Med. 2007;30:385-8.
25. Wallace MA, Fukui MB, Williams RL, Ku A, Baghai P. Complications of cervical selective nerve root blocks performed with fluoroscopic guidance. Am J Roentgenol. 2007;188:1218-21. (Pubitemid 46668501)
26. •• Scanlon GC, Moeller-Bertram T, Romanowsky SM, Wallace MS. Cervical transforaminal epidural steroid injections: more dangerous than we think? Spine. 2007;32:1249-56. Study based on pain physicians survey about serious neurological complications following CTFESIs. (Pubitemid 46743028)
27. Baker R, Dreyfuss P, Mercer S, Bogduk N. Cervical transforaminal injection of corticosteroids into a radicular artery: a possible mechanism for spinal cord injury. Pain. 2003;103:211-5. (Pubitemid 36579101)
28. Lee JY, Nassr A, Ponnappan RK. Epidural hematoma causing paraplegia after a fluoroscopically guided cervical nerve-root injection. A case report. J Bone Joint Surg Am. 2007;89:2037-9. (Pubitemid 350195037)
29. Popescu A, Lai D, Lu A, Gardner K. Stroke following epidural injections-case report and review of literature. J Neuroimaging. 2011. doi: 10.1111/j.1552-6569.2011.00615.x [Epub ahead of print].
30. Stauber B, Ma L, Nazari R. Cardiopulmonary arrest following cervical epidural injection. Pain Physician. 2012;15:147-52.
31. Rozin L, Rozin R, Koehler SA, et al. Death during transforaminal epidural steroid nerve root block (C7) due to perforation of the left vertebral artery. Am J Forensic Med Pathol. 2003;24:351-5. (Pubitemid 37484682)
32. • Furman MB, Giovanniello MT, O'Brien EM. Incidence of intravascular penetration in transforaminal cervical epidural steroid injections. Spine. 2003;28:21-5. Prospective observational clinical study evaluating the incidence of intravascular contrast injection during fluoroscopically-guided CTFESIs. (Pubitemid 36070767)
33. Malhotra G, Abbasi A, Rhee M. Complications of transforaminal cervical epidural steroid injections. Spine. 2009;34:731-9.
34. •• Kim do W, Han KR, Kim C, Chae YJ. Intravascular flow patterns in transforaminal epidural injections: a comparative study of the cervical and lumbar vertebral segments. Anesth Analg. 2009;109:233-9. Prospective observational study comparing cervical and lumbar transforaminal epidural steroid injections and showing the incidence much higher than previously reported.
35. Derby R, Lee SH, Date ES, Lee JH, Lee CH. Size and aggregation of corticosteroids used for epidural injections. Pain Med. 2008;9:227-34. (Pubitemid 351285418)
36. Huntoon MA. Anatomy of the cervical intervertebral foramina: vulnerable arteries and ischemic neurologic injuries after transforaminal epidural injections. Pain. 2005;117:104-11. (Pubitemid 41764777)
37. Hoang JK, Apostol MA, Kranz PG, et al. CT fluoroscopy-assisted cervical transforaminal steroid injection: tips, traps, and use of contrast material. Am J Roentgenol. 2010;195:888-94.
38. Verrills P, Nowesenitz G, Barnard A. Penetration of a cervical radicular artery during a transforaminal epidural injection. Pain Med. 2010;11:229-31.
39. Kranz PG, Raduazo P, Gray L, Kilani RK, Hoang JK. CT fluoroscopy-guided cervical interlaminar steroid injections: safety, technique, and radiation dose parameters. Am J Neuroradiol. 2012;33:1221-4.
40. Khan S, Pioro EP. Cervical epidural injection complicated by syrinx formation: a case report. Spine. 2010;35:E614-6.
41. Kim H, Lee SH, Kim MH. Multislice CT fluoroscopy-assisted cervical transforaminal injection of steroids: technical note. J Spinal Disord Tech. 2007;20:456-61. (Pubitemid 47357504)
42. Narouze SN. Ultrasound-guided interventional procedures in pain management: evidence-based medicine. Reg Anesth Pain Med. 2010;35:S55-8.
43. • McLean JP, Sigler JD, Plastaras CT, Garvan CW, Rittenberg JD. The rate of detection of intravascular injection in cervical transforaminal epidural steroid injections with and without digital subtraction angiography. Pm R. 2009;1:636-42. Retrospective analysis comparing the detection rate of intravascular injections with and without DSA, showing that it improves the detection rate of intravascular injection during CTFESIs.
44. Karasek M, Bogduk N. Temporary neurologic deficit after cervical transforaminal injection of local anesthetic. Pain Med. 2004;5:202-5. (Pubitemid 39029253)
45. Smuck M, Maxwell MD, Kennedy D, Rittenberg JD, Lansberg MG, Plastaras CT. Utility of the anesthetic test dose to avoid catastrophic injury during cervical transforaminal epidural injections. Spine J. 2010;10:857-64.
46. Chung SG. Convulsion caused by a lidocaine test in cervical transforaminal epidural steroid injection. Pm R. 2011;3:674-7.
47. Heavner JE, Racz GB, Jenigiri B, Lehman T, Day MR. Sharp vs blunt needle: a comparative study of penetration of internal structures and bleeding in dogs. Pain Pract. 2003;3:226-31.
48. Smuck M, Leung D. Inadvertent injection of a cervical radicular artery using an atraumatic pencil-point needle. Spine. 2011;36:E220-3.
49. Candido KD, Ghaly RF, Mackerley S, Knezevic NN. A Whitacre-type spinal needle does not prevent intravascular injection during cervical nerve root injections. South Med J. 2010;103:679-82.
50. Heavner JE, Racz GB. Using procedure-specific needles: what is blunt? South Med J. 2010;103:604.