Correlation Between Intravascular Injection Rate, Pain Intensity, and Degree of Cervical Neural Foraminal Stenosis...

Area of Science:

• Pain Medicine
• Interventional Radiology
• Neurosurgery

Background:

• Cervical transforaminal epidural blocks (CTEBs) treat cervical radicular pain.
• Inadvertent intravascular injection during CTEBs can cause serious complications.
• Risk factors for intravascular injection during CTEBs are not well-defined.

Purpose of the Study:

• To investigate the correlation between cervical neural foraminal stenosis (CNFS) severity and intravascular injection incidence during CTEB.
• To assess the impact of CNFS on pain intensity following CTEB.

Main Methods:

• 126 patients with cervical radicular pain were divided into moderate (Group M) and severe (Group S) CNFS groups based on MRI.
• Intravascular injection during CTEB was monitored using real-time fluoroscopy.
• Pain intensity was measured using the Numeric Rating Scale (NRS) before and 1 month after CTEB.

Main Results:

• No significant difference in intravascular injection incidence between moderate (41.3%) and severe (39.7%) CNFS groups (p=0.99).
• No significant difference in NRS scores between groups before or 1 month after CTEB.
• Both groups showed significant pain reduction at 1 month post-procedure compared to baseline.

Conclusions:

• The severity of cervical neural foraminal stenosis does not influence the likelihood of intravascular injection during CTEB.
• Caution is advised during CTEB procedures for patients with both moderate and severe CNFS.
• CTEB effectively reduces pain in patients with cervical radicular pain, irrespective of CNFS severity.