Pain from cervical spinal stenosis? ESI shown to be effective.

Cervical spinal stenosis is the narrowing of the spinal canal which causes compression of the spinal cord. This compression can cause inflammation and pain. An epidural steroid injection (ESI) can help this pain for up to 3 months if oral medications are not helpful.

This study examined 45 patients suffering from neck pain caused by cervical spinal stenosis, and how effective ESI was in managing their pain. Three months following the procedure, over half the patients reported lower pain levels, and more than half were satisfied with the results.

ESI is a minimally invasive procedure, but there are some risks associated with the procedure that you should be aware of.

The Research

World Neurosurg. 2017 Sep 28. pii: S1878-8750(17)31639-X. doi: 10.1016/j.wneu.2017.09.123. [Epub ahead of print]

Effect of Interlaminar Epidural Steroid Injection in Patients with Central Cervical Spinal Stenosis.

Lee DG1, Chang MC2.

Author information

1 Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.

2 Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea. Electronic address: wheel633@ynu.ac.kr.

Abstract

OBJECTIVE:

To investigate the effect of interlaminar epidural steroid injection (ESI) for management of central cervical spinal stenosis-induced posterior neck pain.

METHODS:

This retrospective study recruited 45 patients with posterior neck pain caused by central cervical spinal stenosis. For the ESI procedure, a 21-gauge Touhy needle was inserted into the epidural space between C7 and T1, and 20 mg (40 mg/mL) of dexamethasone with 4 mL of normal saline was injected. The effect of the procedure was evaluated using a numerical rating scale at 1, 2, and 3 months after the procedure. Successful pain relief was defined as reduction in numerical rating scale score of ≥50% compared with before treatment. At 3 months after treatment, patient satisfaction levels were examined; patients who reported very good (score = 7) or good results (score = 6) were considered to be satisfied with the procedure.

RESULTS:

Posterior neck pain was significantly reduced at follow-up evaluation 1, 2, and 3 months after ESI (P < 0.001, repeated measures 1-factor analysis). At 3 months after the procedure, 58% of the patients achieved a successful response (≥50% pain reduction), and 56% were satisfied with treatment results.

CONCLUSIONS:

Cervical interlaminar ESI appears to be a good treatment method for managing chronic posterior neck pain induced by central cervical spinal stenosis, especially when pain is refractory to oral medication.