Comparison of effectiveness for fluoroscopic cervical interlaminar epidural injections with or without steroid in cervical post-surgery syndrome
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Background: Neck and back pain are leading sources of disability placing substantial burden on health care systems. Surgical interventions in managing chronic neck pain secondary to various disorders continue to increase. Even though surgical interventions are effective, a significant proportion of patients continue to have symptomatology and develop cervical post-surgery syndrome. This study was performed to know the effectiveness of cervical interlaminar epidural injections with or without steroids. Methods: The effectiveness of fluoroscopic cervical interlaminar epidural injections in post-surgery syndrome was evaluated in a randomized, active controlled trial. The study population included 116 patients assigned to 2 groups. Group 1 received cervical interlaminar epidural injections with local anesthetic alone and Group 2 received injection with local anesthetic and steroids. The main outcomes were defined as significant improvement (greater than 50%) of pain relief using the numeric rating scale and/or functional status improvement using the Neck Disability Index (NDI).Results: Both groups had similar results with significant improvement (≥ 50% pain relief and functional status improvement) in 69% of the patients in Group I, whereas, in Group II, 71% of the patients showed significant improvement at the end of 2 years. During a 2-year period, the average number of procedures was 5 to 6, with an average of approximately 12 weeks of significant improvement per procedure. Conclusions: Fluoroscopic cervical interlaminar epidural injections administered in cervical post-surgery syndrome using local anesthetic, regardless of the use of steroids, may be effective in approximately 70% of the patients at 2-year follow-up. (Korean J Pain 2018; 31: 277-88)
Abstract
Background: Neck and back pain are leading sources of disability placing substantial burden on health care systems. Surgical interventions in managing chronic neck pain secondary to various disorders continue to increase. Even though surgical interventions are effective, a significant proportion of patients continue to have symptomatology and develop cervical post-surgery syndrome. This study was performed to know the effectiveness of cervical interlaminar epidural injections with or without steroids. Methods: The effectiveness of fluoroscopic cervical interlaminar epidural injections in post-surgery syndrome was evaluated in a randomized, active controlled trial. The study population included 116 patients assigned to 2 groups. Group 1 received cervical interlaminar epidural injections with local anesthetic alone and Group 2 received injection with local anesthetic and steroids. The main outcomes were defined as significant improvement (greater than 50%) of pain relief using the numeric rating scale and/or functional status improvement using the Neck Disability Index (NDI).Results: Both groups had similar results with significant improvement (≥ 50% pain relief and functional status improvement) in 69% of the patients in Group I, whereas, in Group II, 71% of the patients showed significant improvement at the end of 2 years. During a 2-year period, the average number of procedures was 5 to 6, with an average of approximately 12 weeks of significant improvement per procedure. Conclusions: Fluoroscopic cervical interlaminar epidural injections administered in cervical post-surgery syndrome using local anesthetic, regardless of the use of steroids, may be effective in approximately 70% of the patients at 2-year follow-up. (Korean J Pain 2018; 31: 277-88)
참고문헌 (52)
- Nordin M, "The global spine care initiative: a systematic review for the assessment of spine-related complaints in populations with limited resources and in low- and middle-income communities", Eur Spine J (2018)
- Dieleman JL, "US spending on personal health care and public health, 1996-2013", JAMA, 316, pp.2627~2646 (2016)[DOI]
- Dieleman JL, "Factors associated with increase in US health care spending, 1996-2013", JAMA, 318, pp.1668~1678 (2017)[DOI]
- Murray CJ, "The state of US health, 1990-2010: burden of diseases, injuries, and risk factors", JAMA, 310, pp.591~608 (2013)[DOI]
- Mokdad AH, "The state of US health, 1990-2016: burden of diseases, injuries, and risk factors among US states", JAMA, 319, pp.1444~1472 (2018)[DOI]
- Leboeuf-Yde C, "Pain in the lumbar, thoracic or cervical regions: do age and gender matter? a population-based study of 34,902 Danish twins 20-71 years of age", BMC Musculoskelet Disord, 10, pp.39~ (2009)[DOI]
- Hoy D, "The global burden of neck pain: estimates from the global burden of disease 2010 study", Ann Rheum Dis, 73, pp.1309~1315 (2014)[DOI]
- Manchikanti L, "Responsible, safe, and effective prescription of opioids for chronic non-cancer pain: American society of interventional pain physicians (ASIPP) guidelines", Pain Physician, 20, pp.S3~S92 (2017)
- Manchikanti L, "Utilization of interventional techniques in managing chronic pain in medicare population from 2000 to 2014: an analysis of patterns of utilization", Pain Physician, 19, pp.E531~E546 (2016)
- Manchikanti L, "Reversal of growth of utilization of interventional techniques in managing chronic pain in medicare population post affordable care act", Pain Physician, 20, pp.551~567 (2017)
- Manchikanti L, "Facility payments for interventional pain management procedures: impact of proposed rules", Pain Physician, 19, pp.E957~E984 (2016)
- Manchikanti L, "Proposed medicare physician payment schedule for 2017: impact on interventional pain management practices", Pain Physician, 19, pp.E935~E955 (2016)
- Manchikanti L, "Retrospective cohort study of usage patterns of epidural injections for spinal pain in the US fee-for-service Medicare population from 2000 to 2014", BMJ Open, 6, pp.e013042~ (2016)[DOI]
- Bakhsheshian J, "Current diagnosis and management of cervical spondylotic myelopathy", Global Spine J, 7, pp.572~586 (2017)[DOI]
- Derman PB, "Demographic, clinical, and operative factors affecting long-term revision rates after cervical spine arthrodesis", J Bone Joint Surg Am, 98, pp.1533~1540 (2016)[DOI]
- Gutman G, "Surgical treatment of cervical radiculopathy: meta-analysis of randomized controlled trials", Spine (Phila Pa 1976), 43, pp.E365~E372 (2018)
- Patil PG, "National trends in surgical procedures for degenerative cervical spine disease: 1990- 2000", Neurosurgery, 57, pp.753~758 (2005)[DOI]
- [URL]
- Moore A, "Antiepileptic drugs for neuropathic pain and fibromyalgia", JAMA, 312, pp.182~183 (2014)[DOI]
- Manchikanti L, "Cervical zygapophysial (facet) joint pain: effectiveness of interventional management strategies", Postgrad Med, 128, pp.54~68 (2016)[DOI]
- Shamji MF, "Impact of surgical approach on complications and resource utilization of cervical spine fusion: a nationwide perspective to the surgical treatment of diffuse cervical spondylosis", Spine J, 9, pp.31~38 (2009)[DOI]
- Manchikanti L, "Fluoroscopic cervical interlaminar epidural injections in managing chronic pain of cervical postsurgery syndrome: preliminary results of a randomized, double-blind, active control trial", Pain Physician, 15, pp.13~25 (2012)
- Kaye AD, "Efficacy of epidural injections in managing chronic spinal pain: a best evidence synthesis", Pain Physician, 18, pp.E939~E1004 (2015)
- Manchikanti L, "Epidural injections for lumbar radiculopathy and spinal stenosis: a comparative systematic review and meta-analysis", Pain Physician, 19, pp.E365~E410 (2016)
- Manchikanti L, "Cost utility analysis of lumbar interlaminar epidural injections in the treatment of lumbar disc herniation, central spinal stenosis, and axial or discogenic low back pain", Pain Physician, 20, pp.219~228 (2017)
- Laxmaiah Manchikanti, "Therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain: cost utility analysis based on a randomized controlled trial", The Korean Journal of Pain, 31(1), pp.27~38 (2018), 대한통증학회
- Manchikanti L, "Cost utility analysis of cervical therapeutic medial branch blocks in managing chronic neck pain", Int J Med Sci, 14, pp.1307~1316 (2017)[DOI]
- Cleland JA, "Psychometric properties of the neck disability index and numeric pain rating scale in patients with mechanical neck pain", Arch Phys Med Rehabil, 89, pp.69~74 (2008)[DOI]
- Zhai J, "Epidural injection with or without steroid in managing chronic low back and lower extremity pain: a meta-analysis of ten randomized controlled trials", Int J Clin Exp Med, 8, pp.8304~8316 (2015)
- Manchikanti L, "A randomized, double-blind, active control trial of fluoroscopic cervical interlaminar epidural injections in chronic pain of cervical disc herniation: results of a 2-year follow-up", Pain Physician, 16, pp.465~478 (2013)
- Manchikanti L, "Two-year follow-up results of fluoroscopic cervical epidural injections in chronic axial or discogenic neck pain: a randomized, double-blind, controlled trial", Int J Med Sci, 11, pp.309~320 (2014)[DOI]
- Manchikanti L, "Fluoroscopic epidural injections in cervical spinal stenosis: preliminary results of a randomized, double-blind, active control trial", Pain Physician, 15, pp.E59~E70 (2012)
- Manchikanti L, "Results of 2-year follow-up of a randomized, double-blind, controlled trial of fluoroscopic caudal epidural injections in central spinal stenosis", Pain Physician, 15, pp.371~384 (2012)
- Manchikanti L, "Fluoroscopic caudal epidural injections in managing post lumbar surgery syndrome: two-year results of a randomized, double-blind, active-control trial", Int J Med Sci, 9, pp.582~591 (2012)[DOI]
- Tunis SR, "Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy", JAMA, 290, pp.1624~1632 (2003)
- Sherman RE, "Real-world evidence - what is it and what can it tell us?", N Engl J Med, 375, pp.2293~2297 (2016)[DOI]
- [URL]
- Pasqualucci A, "Epidural local anesthetic plus corticosteroid for the treatment of cervical brachial radicular pain: single injection versus continuous infusion", Clin J Pain, 23, pp.551~557 (2007)[DOI]
- Tachihara H, "Do corticosteroids produce additional benefit in nerve root infiltration for lumbar disc herniation?", Spine (Phila Pa 1976), 33, pp.743~747 (2008)[DOI]
- Sato C, "The prolonged analgesic effect of epidural ropivacaine in a rat model of neuropathic pain", Anesth Analg, 106, pp.313~320 (2008)[DOI]
- Song T, "Prolonged suppression of neuropathic pain by sequential delivery of lidocaine and thalidomide drugs using PEGylated graphene oxide", J Pharm Sci, 104, pp.3851~3860 (2015)[DOI]
- Byrod G, "Methylprednisolone reduces the early vascular permeability increase in spinal nerve roots induced by epidural nucleus pulposus application", J Orthop Res, 18, pp.983~987 (2000)[DOI]
- Lee HM, "The role of steroids and their effects on phospholipase A2. An animal model of radiculopathy", Spine (Phila Pa 1976), 23, pp.1191~1196 (1998)[DOI]
- Hayashi N, "The effect of epidural injection of betamethasone or bupivacaine in a rat model of lumbar radiculopathy", Spine (Phila Pa 1976), 23, pp.877~885 (1998)[DOI]
- Pennypacker KR, "Implications of prolonged expression of Fos-related antigens", Trends Pharmacol Sci, 16, pp.317~321 (1995)[DOI]
- Johansson A, "Local corticosteroid application blocks transmission in normal nociceptive C-fibres", Acta Anaesthesiol Scand, 34, pp.335~338 (1990)[DOI]
- Kawakami M, "Experimental lumbar radiculopathy. Behavioral and histologic changes in a model of radicular pain after spinal nerve root irritation with chromic gut ligatures in the rat", Spine (Phila Pa 1976), 19, pp.1795~1802 (1994)[DOI]
- Decosterd I, "Spared nerve injury: an animal model of persistent peripheral neuropathic pain", Pain, 87, pp.149~158 (2000)[DOI]
- Norimoto M, "Direct application of the TNF-alpha inhibitor, etanercept, does not affect CGRP expression and phenotypic change of DRG neurons following application of nucleus pulposus onto injured sciatic nerves in rats", Spine (Phila Pa 1976), 33, pp.2403~2408 (2008)[DOI]
- Genevay S, "Elevated levels of tumor necrosis factor-alpha in periradicular fat tissue in patients with radiculopathy from herniated disc", Spine (Phila Pa 1976), 33, pp.2041~2046 (2008)[DOI]
- Yamashita M, "Tumor necrosis factor-alpha in the nucleus pulposus mediates radicular pain, but not increase of inflammatory peptide, associated with nerve damage in mice", Spine (Phila Pa 1976), 33, pp.1836~1842 (2008)[DOI]