The impact of type 2 diabetes on numeric pain score reduction following cervical transforaminal epidural steroid injections

Abstract

This study aimed to determine whether the presence of type 2 diabetes impairs the therapeutic response to transforaminal cervical epidural steroid injections (TF-CESI) in the treatment of pain due to cervical radiculopathy. This is a retrospective cohort study of patients with cervical radiculopathy who underwent TF-CESI performed by a single physician. Single community-based multidisciplinary pain clinic and ambulatory surgery center. Patients underwent from one to three TF-CESI with dexamethasone or triamcinolone. Change in self-reported numerical pain score. Out of 387 charts reviewed, complete data were available for 329 subjects who underwent TF-CESI from February 2006 through January 2010. The injections consisted of either 40mg triamcinolone or 15mg dexamethasone. Of the 329 total subjects, 35 had type 2 diabetes and 294 did not. The diabetic group had a mean age of 58.1years with standard deviation (SD) of 11.2, mean body mass index (BMI) of 33.1 (SD 7.1), mean pre-procedure pain score of 6.7 (SD 2.2) and mean reduction in pain score of 2.5 (SD 2.4). The non-diabetic group had a mean age of 52.8 (SD 12.4), mean BMI of 28.2 (SD 5.4), mean pre-procedure pain score of 6.7 (SD 1.8), and mean reduction in pain score of 2.4 (SD 2.2). A two-sample ttest with equivalent variance showed no statistically significant difference in the mean reduction in pain score between the diabetic and non-diabetic groups. The patients in the diabetic group were typically older and had higher BMIs. The efficacy of TF-CESI for treating cervical radicular pain in this set of 329 patients was independent of the presence of type 2 diabetes.