Affiliation:
1. Department of Neurosurgery, Spine and Spinal Cord Research Institute, Yonsei University College of Medicine, Seoul, Korea
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.
Key words: Cervical, cervical disc disease, pain management, percutaneous epidural neuroplasty,
percutaneous adhesiolysis, epidural steroid injection
Publisher
American Society of Interventional Pain Physicians
Subject
Anesthesiology and Pain Medicine
Cited by
4 articles.
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