Randomized controlled study of percutaneous epidural neuroplasty using Racz catheter and epidural steroid injection in cervical disc disease

Guy Yeul Ji, Chang Hyun Oh, Keun Su Won, In Bo Han, Yoon Ha, DongAh Shin, Keung Nyun Kim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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 study. Setting: University hospital center. Methods: Eighty patients with neck pain from single level cervical disease with and without radiculopathy were included in this study. Patients were randomly assigned into 2 groups: C-PEN or C-ESI. Clinical outcomes were assessed according to Neck Disability Index (NDI) score and Visual Analog Scale (VAS) score for arm pain until 12 months after treatment. Results: All C-PEN and C-ESI groups showed better NDI recovery and greater reduction in VAS score at postoperative 6 months (P < 0.001). The C-PEN group demonstrated better NDI score at postoperative 6 months than the C-ESI group (P = 0.014), while there were no differences at 2, 4, and 12 months. Additionally, the C-PEN group showed lower VAS scores at all follow-up intervals compared to the C-ESI group (P < 0.050). Symptom relief was sustained for a significantly longer duration in the C-PEN group than in the C-ESI group (23.4 vs. 20.5 weeks, P < 0.001). Limitations: The follow-up period was relatively short with a small sample size, and the grade of cervical disc disease, root compression, and disc degeneration grade were could not considered in this study. Conclusions: C-PEN was superior to C-ESI in terms of better NDI recovery (at 6 months) and greater reduction in VAS score (until 12 months) in treating single level cervical disc herniation. Better outcomes with C-PEN may have been achieved via a more localized selective block in the epidural space closer to the dorsal root ganglion and ventral aspect of the nerve root.

Original languageEnglish
Pages (from-to)39-47
Number of pages9
JournalPain Physician
Volume19
Issue number2
Publication statusPublished - 2016 Feb 1

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Epidural Injections
Catheters
Steroids
Visual Analog Scale
Neck
Intervertebral Disc Degeneration
Epidural Space
Radiculopathy
Neck Pain
Spinal Ganglia
Sample Size
Arm
Pain

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Ji, Guy Yeul ; Oh, Chang Hyun ; Won, Keun Su ; Han, In Bo ; Ha, Yoon ; Shin, DongAh ; Kim, Keung Nyun. / Randomized controlled study of percutaneous epidural neuroplasty using Racz catheter and epidural steroid injection in cervical disc disease. In: Pain Physician. 2016 ; Vol. 19, No. 2. pp. 39-47.
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abstract = "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 study. Setting: University hospital center. Methods: Eighty patients with neck pain from single level cervical disease with and without radiculopathy were included in this study. Patients were randomly assigned into 2 groups: C-PEN or C-ESI. Clinical outcomes were assessed according to Neck Disability Index (NDI) score and Visual Analog Scale (VAS) score for arm pain until 12 months after treatment. Results: All C-PEN and C-ESI groups showed better NDI recovery and greater reduction in VAS score at postoperative 6 months (P < 0.001). The C-PEN group demonstrated better NDI score at postoperative 6 months than the C-ESI group (P = 0.014), while there were no differences at 2, 4, and 12 months. Additionally, the C-PEN group showed lower VAS scores at all follow-up intervals compared to the C-ESI group (P < 0.050). Symptom relief was sustained for a significantly longer duration in the C-PEN group than in the C-ESI group (23.4 vs. 20.5 weeks, P < 0.001). Limitations: The follow-up period was relatively short with a small sample size, and the grade of cervical disc disease, root compression, and disc degeneration grade were could not considered in this study. Conclusions: C-PEN was superior to C-ESI in terms of better NDI recovery (at 6 months) and greater reduction in VAS score (until 12 months) in treating single level cervical disc herniation. Better outcomes with C-PEN may have been achieved via a more localized selective block in the epidural space closer to the dorsal root ganglion and ventral aspect of the nerve root.",
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Randomized controlled study of percutaneous epidural neuroplasty using Racz catheter and epidural steroid injection in cervical disc disease. / Ji, Guy Yeul; Oh, Chang Hyun; Won, Keun Su; Han, In Bo; Ha, Yoon; Shin, DongAh; Kim, Keung Nyun.

In: Pain Physician, Vol. 19, No. 2, 01.02.2016, p. 39-47.

Research output: Contribution to journalArticle

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AU - Ji, Guy Yeul

AU - Oh, Chang Hyun

AU - Won, Keun Su

AU - Han, In Bo

AU - Ha, Yoon

AU - Shin, DongAh

AU - Kim, Keung Nyun

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AB - 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 study. Setting: University hospital center. Methods: Eighty patients with neck pain from single level cervical disease with and without radiculopathy were included in this study. Patients were randomly assigned into 2 groups: C-PEN or C-ESI. Clinical outcomes were assessed according to Neck Disability Index (NDI) score and Visual Analog Scale (VAS) score for arm pain until 12 months after treatment. Results: All C-PEN and C-ESI groups showed better NDI recovery and greater reduction in VAS score at postoperative 6 months (P < 0.001). The C-PEN group demonstrated better NDI score at postoperative 6 months than the C-ESI group (P = 0.014), while there were no differences at 2, 4, and 12 months. Additionally, the C-PEN group showed lower VAS scores at all follow-up intervals compared to the C-ESI group (P < 0.050). Symptom relief was sustained for a significantly longer duration in the C-PEN group than in the C-ESI group (23.4 vs. 20.5 weeks, P < 0.001). Limitations: The follow-up period was relatively short with a small sample size, and the grade of cervical disc disease, root compression, and disc degeneration grade were could not considered in this study. Conclusions: C-PEN was superior to C-ESI in terms of better NDI recovery (at 6 months) and greater reduction in VAS score (until 12 months) in treating single level cervical disc herniation. Better outcomes with C-PEN may have been achieved via a more localized selective block in the epidural space closer to the dorsal root ganglion and ventral aspect of the nerve root.

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