Efficacity of CT-guided intra-articular cervical facet steroid injection for cervical radiculopathy

Traditionally, transforaminal steroid injection is performed in the management of cervical radiculopathy in medical failure treatment but carried a true risk of catastrophic complication. Another approach currently used is to perform intra-articular facet steroid injection to reach the epidural space.

The aim of this study was to describe the evolution of symptoms following intra-articular facet steroid injection in cervical radiculopathy.

We conducted a retrospective study. We assessed all patients who had a CT-guided intra-articular facet steroid injection in our center (xx, xx, xx) from December 2015 to February 2021. Cervical MR pretherapeutic images were analyzed and classified according to cervical pain etiology: uncodiscarthrosis, disk herniation or congestive cervical posterior osteo-arthritis. All patients had clinical initial evaluation and then follow-up at 1 and 6 months. Pain severity was rated on a visual analog scale and expressed as a percentage of improvement.

Ninety-three patients were included. There were 56 patients with uncodiscarthrosis, 29 with a disk herniation and 8 with a cervical posterior congestive osteoarthritis. A significant improvement of the visual analog scale percentage was found for all patient at 1 and 6 months (p < 0.01). Visual analog scale percentage improvement was about 50 % for all etiologies. For all patients, no severe complications were reported.

Intra-articular facet steroid injection may be considered for the treatment of cervical radiculopathy when other medical treatments have failed.