CT-Guided Epidural/Perineural Injections in Painful Disorders of the Lumbar Spine:Short- and Extended-Term Results
- Department of Diagnostic Radiology and Nuclear Medicine, St. Josef Hospital, University Hospital Bochum, Gudrunstrasse 56, D-44791 Bochum (Germany)
- Department of Diagnostic Imaging, Nuclear Medicine and Interventional Radiology, Diakonissenkrankenhaus Karlsruhe-Rueppurr, Diakonissenstrasse 28, D-76199 Karlsruhe-Rueppurr (Germany)
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.
- OSTI ID:
- 21080254
- Journal Information:
- Cardiovascular and Interventional Radiology, Vol. 22, Issue 6; Other Information: DOI: 10.1007/s002709900438; Copyright (c) 1999 Springer-Verlag New York Inc; Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
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