Comparative Effectiveness of Parasagittal Interlaminar and Transforaminal Cervical Epidural Steroid Injection in Patients with Cervical Radicular Pain: A Randomized Clinical Trial

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研究概要

Eighty patients with cervical radicular pain were randomized to receive a cervical epidural steroid injection via a parasagittal interlaminar (IL) approach (n=40) or transforaminal (TF) approach (n=40). The primary outcome of interest was pain evaluated using the Numeric Rating Scale (NRS) at 1 and 3 months post-intervention. Secondary outcomes of interest were the Neck Disability Index (NDI), the Medication Quantification Scale (MQS), and the incidence of successful responders. Specifically, parameters that comprised successful responders included the following: ≥50%/4 point reduction in NRS, ≥30%/2 point reduction in NRS, ≥30%/10 point reduction in NDI, increase in NDI, ≥25% reduction in MQS, and an increase in MQS. All secondary outcomes were also measured at 1 and 3 months follow-up. Moreover, adverse events were recorded. Results revealed that NRS pain was statistically significantly reduced in the TF group vs. IL group (p=0.01) at 1 month follow-up only. NDI and MQS scores, as well as incidence of successful responders, were not statistically significantly different between the 2 approaches at any of the timepoints (p>0.05 for all). A statistically significant difference was observed across all groups for incidence of adverse events, with a lower number in the IL group (n=12) vs TF group (n=2).