Hasoon Jamal, Chu Kenzie, Chu Wesley, Govindaraj Ranganathan
Department of Anesthesiology, Critical Care, and Pain Medicine The University of Texas Health Science Center at Houston.
Saint John's School.
Orthop Rev (Pavia). 2024 Oct 30;16:124767. doi: 10.52965/001c.124767. eCollection 2024.
Cervical radiculopathy is characterized by pain, numbness, and weakness in the upper limbs. This is typically caused by nerve root compression. While conservative treatments like physical therapy and oral analgesics are often used, they may not be effective in more severe cases. Cervical epidural steroid injections (CESIs), particularly through the interlaminar approach, may be considered when these initial treatments fail. This case report discusses a female patient with severe left upper extremity pain consistent with C5/6 and C6/7 radiculopathy who did not respond to conservative therapies. An interlaminar CESI was initially performed at the C7/T1 level, but the contrast flow was inadequate for effective drug delivery. Repositioning the needle at the C6/C7 interspace improved contrast distribution, successfully targeting the affected levels. The patient experienced a 90% reduction in symptoms three weeks after the procedure, underscoring the importance of accurate contrast flow assessment and needle placement in CESIs. This case highlights the effectiveness of CESI in treating cervical radiculopathy and the critical role of precise technique in achieving positive patient outcomes.
神经根型颈椎病的特点是上肢疼痛、麻木和无力。这通常是由神经根受压引起的。虽然经常使用物理治疗和口服镇痛药等保守治疗方法,但在病情较严重的情况下可能无效。当这些初始治疗失败时,可考虑采用颈椎硬膜外类固醇注射(CESI),尤其是经椎间孔入路。本病例报告讨论了一名患有与C5/6和C6/7神经根病相符的严重左上肢疼痛且对保守治疗无反应的女性患者。最初在C7/T1水平进行了椎间孔CESI,但造影剂流动不足,无法有效给药。将针重新定位到C6/C7间隙改善了造影剂分布,成功地靶向了受影响的节段。术后三周患者症状减轻了90%,强调了在CESI中准确评估造影剂流动和针头放置的重要性。本病例突出了CESI在治疗神经根型颈椎病中的有效性以及精确技术在实现患者良好预后方面的关键作用。