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Evaluating the effectiveness of interlaminar epidural steroid injections for cervical radiculopathy using PROMIS as an outcome measure.

作者信息

Stephens Andrew R, Bender Nicholas R, Snyder Jim M, Patel Rajeev K, El-Hassan Ramzi

机构信息

University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14623, USA.

出版信息

Interv Pain Med. 2024 Dec 5;3(4):100528. doi: 10.1016/j.inpm.2024.100528. eCollection 2024 Dec.


DOI:10.1016/j.inpm.2024.100528
PMID:39717451
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11664393/
Abstract

BACKGROUND: Cervical interlaminar epidural steroid injections (CIESI) are frequently used to treat cervical radiculopathy due to cervical nerve root impingement. OBJECTIVE: The purpose of this study was to evaluate the therapeutic effect of CIESI for patients with cervical radiculopathy. METHODS: We conducted a retrospective review of consecutive adult patients with cervical radicular pain and corroborative cervical spondylotic foraminal stenosis on MRI that failed at least 6 weeks of conservative management consisting of medication and physical rehabilitation seen at a multidisciplinary, tertiary academic spine center. Patient Reported Outcome Measurement Information System (PROMIS) domains of Physical Function (PF) v1.2/v2.0 and Pain Interference (PI) v1.1 were collected at all patient visits. Scores were recorded at baseline, 3-months, 6-months and 12-months post-procedure. Statistical analysis comparing baseline scores with follow-up postprocedural PROMIS scores was performed. The percentage of patients reporting improvement greater than the minimal clinically important difference (MCID) was calculated for responders and for the worst case scenario. RESULTS: 179 patients met inclusion criteria. PROMIS PI at 3-, 6-, and 12-month follow-up statistically improved by 1.5 (95 % confidence interval [CI] 1.4-1.6; p = 0.02), 1.5 (95 % CI 1.4-1.6; p = 0.03) and 1.7 (95 % CI 1.6-1.8; p = 0.4), respectively. Follow-up PROMIS PF at 3-month follow-up improved by 1.6 (95 % CI 1.5-1.7; p = 0.04) but did not significantly differ at 6- or 12-month follow-up. The percentage of patients that exceeded MCID thresholds of clinical significance was 44 % (95 % CI 36%-53 %) at 3-months, 49 % (95 % CI 39%-59 %) at 6-months, and 54 % (95 % CI 41%-66 %) at 12-months. Worst case scenario analysis demonstrated that 32 % (95 % CI 36%-53 %) of patients exceeded the MCID thresholds at 3-months, 31 % (95 % CI 24%-37 %) at 6-months, and 21 % (95 % CI 15%-27 %) at 12-months. DISCUSSION/CONCLUSIONS: Our study demonstrated that CIESI leads to an improvement in function and pain for patients with cervical radiculopathy. This study was limited by retrospective design, loss to follow-up, and variation in steroids used.

摘要

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引用本文的文献

[1]
Evaluation of fluoroscopically guided transforaminal epidural steroid injections for cervical radiculopathy utilizing patient reported outcome measurement information system as an outcome measure.

Interv Pain Med. 2025-3-1

本文引用的文献

[1]
FACTFINDERS FOR PATIENT SAFETY: Minimizing risks with cervical epidural injections.

Interv Pain Med. 2024-8-27

[2]
An update on technical and safety practice patterns of interlaminar epidural steroid injections.

Interv Pain Med. 2023-11-29

[3]
Results of lumbar transforaminal epidural steroid injections based on the physician referral source.

Interv Pain Med. 2022-7-31

[4]
Evaluation of Fluoroscopically Guided Transforaminal Selective Nerve Root Sleeve Injections for Lumbar Spinal Stenosis With Radiculopathy Utilizing Patient Reported Outcome Measurement Information System as an Outcome Measure.

Arch Phys Med Rehabil. 2024-8

[5]
First-Time Lumbar Medial Branch Radiofrequency Ablation: Patient-Reported Outcomes Measurement Information System as a Metric of Outcome.

Arch Phys Med Rehabil. 2022-12

[6]
Safety of Interlaminar Cervical Epidural Injections: Experience With 12,168 Procedures in a Single Pain Clinic.

Pain Physician. 2022-1

[7]
Preoperative PROMIS Scores Predict Postoperative Outcomes in Lumbar Spine Surgery Patients.

Spine (Phila Pa 1976). 2021-9-1

[8]
Comparative Effectiveness of Parasagittal Interlaminar and Transforaminal Cervical Epidural Steroid Injection in Patients with Cervical Radicular Pain: A Randomized Clinical Trial.

Pain Physician. 2021-3

[9]
Development of prediction models for clinically meaningful improvement in PROMIS scores after lumbar decompression.

Spine J. 2021-3

[10]
Evaluation of transforaminal epidural steroid injections for discogenic axial lumbosacral back pain utilizing PROMIS as an outcome measure.

Spine J. 2021-2

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