Surgery Prevention by Transforaminal Injection of Epidural Steroids for Cervical Radicular Pain
Status:
Active, not recruiting
Trial end date:
2021-12-01
Target enrollment:
Participant gender:
Summary
Cervical radicular pain is a common cause of disability and pain in the upper extremity and
neck with an annual incidence of 83.2/100,000 (1). The initial treatment is conservative and
includes relative rest, use of anti-inflammatory and analgesic medication, as well as
physical therapy and home exercise. For patients who have persistent and significant
symptoms, interventional pain management and surgical management are considered. Cervical
epidural injections are the mainstay of the interventional, non-surgical modalities. They can
be considered to provide short and long-term relief when disc herniation, foraminal stenosis
or central canal stenosis pathology is identified. We are not aware of any published
prospective, randomized, controlled, double-blinded studies demonstrating the efficacy of
cervical transforaminal epidural steroid injections. However, the North American Spine
Society (NASS) Review and Recommendation Statement states that based on the literature and
expert opinion, a minimum of one or two cervical epidural steroid injections would be very
appropriate in the treatment of a specific episode of cervical radicular pain.
The purpose of this study is to determine the effectiveness of cervical transforaminal
epidural steroid injections in decreasing the need for an operation in patients with cervical
radicular pain, otherwise considered to be operative candidates.