CT-guided epidural/perineural injections in painful disorders of the lumbar spine: Short- and extended-term results |
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Authors: | Gebhard Schmid M.D. Sylvia Vetter Dieter Göttmann Ernst-Peter Strecker |
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Affiliation: | (1) Department of Diagnostic Radiology and Nuclear Medicine, St. Josef Hospital, University Hospital Bochum, Gudrunstrasse 56, D-44791 Bochum, Germany, DE;(2) Department of Diagnostic Imaging, Nuclear Medicine and Interventional Radiology, Diakonissenkrankenhaus Karlsruhe-Rüppurr, Diakonissenstrasse 28, D-76199 Karlsruhe-Rüppurr, Germany, DE |
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Abstract: | Purpose: Evaluation of short- and extended-term results of repeated epidural/perineural injections (EDT/PRT) of corticoids in painful afflictions of the lumbar spine. Methods: Thirty-two patients who had persistent radicular or low back pain for more than 6 weeks were treated with CT-guided injection therapy. By EDT/PRT, 40 mg of triamcinolonacetonid was injected either periradicularly or by a direct intraspinal epidural method at intervals of 3 weeks. Altogether, 140 EDT/PRT were performed in 32 patients (mean 4.4, range 2–8). In nine patients partial facet joint denervation with 1–2 ml of 50% alcohol solution was combined with EDT/PRT to reduce low back pain. Before and after treatment and at follow-up (mean 9.6 months), treatment success was evaluated on a visual analog scale and by physical examination (good = >50% improvement, moderate = 20%–50%, no improvement = <20%). Results: Short-term (end of therapy) good or moderate improvement was achieved in 91% of patients, extended-term (mean 9.6 months) in 56%. Regarding certain subgroups, those with disc herniations of the lumbar spine showed a better outcome with good or moderate improvement in 95% short-term and 69% extended-term than those with spinal stenosis who had 72% short-term and 28% long-term. Conclusion: Results indicate that CT-guided EDT/PRT in combination with partial facet joint denervation is a safe and effective outpatient treatment. |
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Keywords: | : Computed tomography, guidance— Spine, interventional procedure— Epidural, perineural |
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