C7-T1 Epidural Steroid Injections Versus Targeted Injection Via Cervical Epidural Catheter for Treatment of Cervical Radicular Pain
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Neurology, Orthopedic, Pain |
| Therapuetic Areas: | Musculoskeletal, Neurology, Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 4/27/2016 |
| Start Date: | March 2014 |
A Prospective Randomized Controlled Trial of Standardized C7-T1 Epidural Steroid Injections Versus Targeted Injection Via Cervical Epidural Catheter for the Treatment of Cervical Radicular Pain
Cervical radicular pain is a common, disabling problem, occurs in 83:100,000 individuals per
year. Symptoms are most often caused by intervertebral disc herniation (21.9%) or central or
foraminal stenosis from spondylosis (68.4%). Patients complain of pain in the head, neck,
scapula or arm. The diagnosis of radicular pain is made clinically by history and physical
examination, supported by imaging studies and electrodiagnostic tests. No study has compared
the differences in pain, medication utilization, functional outcomes, or patient
satisfaction between interlaminar and targeted epidural injections in the cervical spine. In
theory, the technique of targeted epidural steroid delivery with a catheter has a lower risk
of accidental vascular trespass or disc penetration during the procedure, and far less risk
of dural penetration or spinal cord injury at rostral levels of the cervical spinal cord as
compared with the interlaminar technique. The investigators hypothesize that this technique
results in superior pain control, decreased medication use, improved function and fewer
repeat injections. This data could improve patient safety and affect the evolving treatment
guidelines for cervical epidural injections.
year. Symptoms are most often caused by intervertebral disc herniation (21.9%) or central or
foraminal stenosis from spondylosis (68.4%). Patients complain of pain in the head, neck,
scapula or arm. The diagnosis of radicular pain is made clinically by history and physical
examination, supported by imaging studies and electrodiagnostic tests. No study has compared
the differences in pain, medication utilization, functional outcomes, or patient
satisfaction between interlaminar and targeted epidural injections in the cervical spine. In
theory, the technique of targeted epidural steroid delivery with a catheter has a lower risk
of accidental vascular trespass or disc penetration during the procedure, and far less risk
of dural penetration or spinal cord injury at rostral levels of the cervical spinal cord as
compared with the interlaminar technique. The investigators hypothesize that this technique
results in superior pain control, decreased medication use, improved function and fewer
repeat injections. This data could improve patient safety and affect the evolving treatment
guidelines for cervical epidural injections.
Inclusion Criteria:
- All patients ages 18-75 with C2-6 unilateral radicular pain who are scheduled to
undergo cervical epidural steroid injection treatment.
- Pain lasting greater than 2 weeks.
- Pain resistant to a trial of conservative therapy (i.e. oral steroids,nonsteroidal
anti-inflammatory drugs, opioids, muscle relaxants, physical therapy or chiropractic
care)
Exclusion Criteria:
- Patient refusal.
- Lack of consent.
- Systemic infection or local infection over planned injection site in posterior
cervical spine.
- Bleeding disorder, current use of anticoagulants or anti-platelet medications.
- Intrinsic spinal cord lesions in the cervical region.
- History of central neurologic, cerebrovascular, demyelinating or muscular disease.
- Concomitant use of oral or injected steroids.
- Allergy to medications being used for injection procedures.
- Inability to communicate with staff or to participate in follow up.
- Pregnancy.
- Inability to perform handgrip or arm strength testing.
- Cognitive deficit or motor neuron disease.
- Daily opiate use that preceded the onset of cervical radicular symptoms or daily
opiate use exceeding 3 months prior to study inclusion
We found this trial at
1
site
303 E Chicago Ave
Chicago, Illinois 60611
Chicago, Illinois 60611
(312) 503-8194
Northwestern University Feinberg School of Medicine Northwestern University Feinberg School of Medicine, founded in 1859,...
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