CT-guided Interventional Therapy of Back Pain - Predictors of Success in Treatment

The aim of the presented study was to investigate if distribution of the drug-contrast medium mixture in CT-guided periradicular therapy can predict intervention success.

Over a 15-month period, 97 patients admitted to our institution by a pain physician for CT guided periradicular therapy were treated. In 420 CT guided interventions, we measured the relative distribution of the drug mixture in relationship to the neuroforamen. The distribution was correlated to the patient's pain score over time. In addition, dependence of success in treatment with regards to the treating physician was evaluated.

Ninety percent of the patients experienced a decrease of pain score under therapy, only 10 % showed no change. On average there was an improvement in pain score from 7.4 (2-10) before therapy to 3.7 (0-9) at the end of therapy. We observed a weak correlation of -0.22 (p < 0.028) between distribution of drug mixture to the neuroforamen and reduction of pain score. The therapy outcome displayed a dependency regarding the treating physician (p < 0.0084).

CT guided periradicular therapy offers good pain reduction in most of the patients. Drug distribution near the affected nerve and treating physician are factors for clinical success.

· CT-guided periradicular therapy shows a good or very good improvement in the symptoms in 90 % of the treated patients.. · In addition to technical performance, the treating radiologist is an important parameter determining success.. · The success of CT-guided treatment is only moderately correlated with an absolute distribution of the drug mixture..

· Stueckle CA, Talarczyk S, Hackert B et al. CT-guided Interventional Therapy of Back Pain - Predictors of Success in Treatment. Fortschr Röntgenstr 2021; 193: 42 - 48.