[Evaluation of CT guided cervical epidural injections in patients with mechanical cervicobrachial neuralgia].

PURPOSE

Prospective study evaluating the efficacy and tolerability of CT guided cervical epidural injections for mechanical cervicobrachial neuralgia.

MATERIALS AND METHODS

Between July 2003 and August 2004, 34 patients (16 females, 18 males) with mean age of 44.5 years were enrolled. Enrollment criteria included mechanical cervicobrachial neuralgia of more than 1 month's duration, refractory to medical management, with good correlation between clinical and imaging findings. An evaluation using the Neck Pain Disability Score (NPDS) and associated Secondary criteria was performed by a single observer at day 0, day 30 and day 90. The injections were performed under CT guidance.

RESULTS

The symptomatic efficacy of CT guided injections at 3 months was 45% using the NPDS, 47.1% using an analog pain scale, and 58.8% as graded by patients (effective/very effective). Tolerability was excellent (55.9%), moderate (41.2%) and poor (2.9%).

CONCLUSION

CT guided cervical epidural injections appear effective and well-tolerated. A blinded randomized study could validate its value. However, a study comparing steroids and placebo raises ethical concerns.