Assessment of clinical outcomes of cervical epidural neuroplasty using a Racz-catheter and predictive factors of efficacy in patients with cervical spinal pain.

نویسندگان

  • Dong Eon Moon
  • Hae Jung Park
  • Young Hoon Kim
چکیده

BACKGROUND Epidural neuroplasty using the Racz catheter has a therapeutic effect in patients with cervical disc herniation and central stenosis who do not respond to fluoroscopically guided epidural injections. OBJECTIVE To evaluate the clinical outcomes of cervical epidural neuroplasty in patients with posterior neck and upper extremity pain and to demonstrate correlations between predictive factors and unsuccessful results of cervical epidural neuroplasty. STUDY DESIGN Observational study. SETTING An interventional pain management practice in a university hospital. METHODS Outcome measures were obtained using the numeric rating scale (NRS) for total pain, neck pain, arm pain, and sleep disturbance; and the neck pain and disability scale (NPDS); as well as opioid consumption at preprocedure, one month, 3, 6, and 12 months after procedure. Successful epidural neuroplasty was defined as 50% or greater reduction from the preprocedure NRS for total pain, and at least a 40% reduction in the NPDS. We obtained clinical data and radiologic findings to evaluate correlations between predictive factors and efficacy of epidural neuroplasty. RESULTS Of the 169 patients, successful outcomes were observed in 108 patients (63.9%) at one month following the procedure, in 109 patients (64.5%) at 3 months, in 96 patients (56.8%) at 6 months, and in 89 patients (52.7%) at 12 months. Previous surgery, spondylolisthesis, and ossification of the posterior longitudinal ligament were significantly associated with unsuccessful outcomes as measured by NRS and NPDS (P < 0.05). LIMITATIONS Limitations of this evaluation include the lack of a placebo group. CONCLUSIONS Cervical epidural neuroplasty may be an effective treatment for pain reduction and functional improvement in patients with cervical spinal pain who did not respond to conservative treatment, and may decrease surgical demand. Previous surgery, spondylolisthesis, and ossification of the posterior longitudinal ligament are associated with unsuccessful outcomes of epidural neuroplasty.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Randomized Controlled Study of Percutaneous Epidural Neuroplasty Using Racz Catheter and Epidural Steroid Injection in Cervical Disc Disease.

BACKGROUND The efficacy of lumbar percutaneous epidural neuroplasty (PEN) as a minimally invasive technique has been relatively well investigated, but the clinical effectiveness of cervical PEN (C-PEN) has yet to be established. OBJECTIVE The purpose of this study was to compare clinical outcomes between C-PEN and cervical epidural steroid injection (C-ESI). STUDY DESIGN Randomized control ...

متن کامل

Surgical treatment of a broken neuroplasty catheter in the epidural space: a case report

BACKGROUND Percutaneous epidural neuroplasty with a Racz catheter is widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. The breakage or shearing of an epidural catheter, particularly a percutaneous epidural neuroplasty catheter, is reported as a rare complication. There has been a controversy over whether surgical removal of a shorn epidural cathet...

متن کامل

Clinical Outcomes of Epidural Neuroplasty for Cervical Disc Herniation

Cervical disc herniation is a common disorder characterized by neck pain radiating to the arm and fingers as determined by the affected dermatome. This condition has a favorable prognosis, but pain can have a serious detrimental impact on daily activities. Epidural neuroplasty has been applied as a treatment option for cervical disc herniation; however, no study has addressed the clinical outco...

متن کامل

Preliminary results of the clinical effectiveness of percutaneous adhesiolysis using a Racz catheter in the management of chronic pain due to cervical central stenosis.

BACKGROUND Cervical central stenosis (CCS) is a narrowing of the spinal canal that can cause mechanical compression of the spinal nerve and roots, leading to neck pain and/or radicular pain. Cervical epidural steroid injections are commonly used in the treatment of CCS. After failure of epidural steroid injections, the next sequential step is percutaneous adhesiolysis with a targeted drug deliv...

متن کامل

Non-traumatic Causes of Brown-Sequard Syndrome: A Case Series and Clinical Update with Systematic Review.

Background: Brown-Sequard syndrome (BSS) is a rare neurological condition resulting from a hemisection injury to or unilateral compression on the spinal cord. The most common causes of BSS that are amenable to be treated surgically can be divided into traumatic and non-traumatic injuries. Traumatic injuries are often reported as the main cause of BSS. However, non-traumatic injuries of the spin...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Pain physician

دوره 18 2  شماره 

صفحات  -

تاریخ انتشار 2015