Effect of Interlaminar Epidural Steroid Injection in Patients with Central Cervical Spinal Stenosis.

Abstract

To investigate the effect of interlaminar epidural steroid injection (ESI) for management of central cervical spinal stenosis-induced posterior neck pain. This retrospective study recruited 45 patients with posterior neck pain caused by central cervical spinal stenosis. For the ESI procedure, a 21-gauge Touhy needle was inserted into the epidural space between C7 and T1, and 20 mg (40 mg/mL) of dexamethasone with 4 mL of normal saline was injected. The effect of the procedure was evaluated using a numerical rating scale at 1, 2, and 3 months after the procedure. Successful pain relief was defined as reduction in numerical rating scale score of ≥50% compared with before treatment. At 3 months after treatment, patient satisfaction levels were examined; patients who reported very good (score= 7) or good results (score= 6) were considered to be satisfied with the procedure. Posterior neck pain was significantly reduced at follow-up evaluation 1, 2, and 3 months after ESI (P < 0.001, repeated measures 1-factor analysis). At 3 months after the procedure, 58% of the patients achieved a successful response (≥50% pain reduction), and 56% were satisfied with treatment results. Cervical interlaminar ESI appears to be a good treatment method for managing chronic posterior neck pain induced by central cervical spinal stenosis, especially when pain is refractory to oral medication.