Comparative analysis of contrast distribution in cervical epidural steroid injections utilizing a modified paramedian interlaminar approach with varied needle tip positions: A randomized controlled trial.

IF 2.5 3区 医学 Q2 ANESTHESIOLOGY Pain Practice Pub Date : 2024-11-01 Epub Date: 2024-08-02 DOI:10.1111/papr.13401
Seung Hee Yoo, Min Jin Lee, Mi Jin Jue, Yoonsun Won, Won-Joong Kim
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Abstract

Background: Recent advancements in cervical interlaminar epidural steroid injections have given rise to the modified paramedian interlaminar (mPIL) approach. The objective of this study was to perform an analysis of the contrast spread pattern within the cervical epidural space, taking into account different needle tip positions in the mPIL approach.

Methods: A total of 48 patients were included in the study and randomly assigned to either the medial or lateral group based on the needle tip's position in the anterior-posterior view. The primary outcome measured was the contrast flow under fluoroscopic visualization. As a secondary outcome, we analyzed the location of the needle tip position in both lateral and contralateral oblique views. Clinical effectiveness was assessed by measuring pain intensity and functional disability post-procedure.

Results: Significant disparities were noted in the ventral distribution of contrast between the medial and lateral groups. In the lateral images, needle tips in the lateral group were positioned more ventrally compared to those in the medial group. Both groups exhibited statistically significant improvements in neck and radicular pain, as well as functional status, 4 weeks after treatment, with no significant differences between them.

Conclusions: Our results suggest that the ventral dispersion of contrast material during cervical interlaminar epidural steroid injections using the mPIL approach may vary depending on the needle tip location.

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采用改良的旁侧层间注射法和不同针尖位置的颈椎硬膜外类固醇注射对比分析:随机对照试验。
背景:颈椎层间硬膜外类固醇注射的最新进展催生了改良副束层间注射法(mPIL)。本研究的目的是根据 mPIL 方法中不同的针尖位置,对颈椎硬膜外腔内的对比剂扩散模式进行分析:研究共纳入 48 名患者,根据针尖在前后视图中的位置随机分配到内侧组或外侧组。测量的主要结果是透视下的造影剂流量。作为次要结果,我们分析了针尖在侧方和对侧斜视图中的位置。临床效果通过测量术后疼痛强度和功能障碍来评估:结果:内侧组和外侧组对比度的腹侧分布存在显著差异。在侧位图像中,与内侧组相比,外侧组的针尖位置更偏向腹侧。治疗 4 周后,两组患者的颈部和根部疼痛以及功能状态均有明显改善,差异无统计学意义:我们的研究结果表明,使用 mPIL 方法进行颈椎层间硬膜外类固醇注射时,造影剂的腹侧弥散可能因针尖位置而异。
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来源期刊
Pain Practice
Pain Practice ANESTHESIOLOGY-CLINICAL NEUROLOGY
CiteScore
5.60
自引率
3.80%
发文量
92
审稿时长
6-12 weeks
期刊介绍: Pain Practice, the official journal of the World Institute of Pain, publishes international multidisciplinary articles on pain and analgesia that provide its readership with up-to-date research, evaluation methods, and techniques for pain management. Special sections including the Consultant’s Corner, Images in Pain Practice, Case Studies from Mayo, Tutorials, and the Evidence-Based Medicine combine to give pain researchers, pain clinicians and pain fellows in training a systematic approach to continuing education in pain medicine. Prior to publication, all articles and reviews undergo peer review by at least two experts in the field.
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