Purpose: Prospective study evaluating the efficacy and tolerability of CT guided cervical epidural injections for mechanical cervicobrachial neuralgia.
Materials and methods: Between July 2003 and August 2004, 34 patients (16 females, 18 males) with mean age of 44.5 years were enrolled. Enrollment criteria included mechanical cervicobrachial neuralgia of more than 1 month's duration, refractory to medical management, with good correlation between clinical and imaging findings. An evaluation using the Neck Pain Disability Score (NPDS) and associated Secondary criteria was performed by a single observer at day 0, day 30 and day 90. The injections were performed under CT guidance.
Results: The symptomatic efficacy of CT guided injections at 3 months was 45% using the NPDS, 47.1% using an analog pain scale, and 58.8% as graded by patients (effective/very effective). Tolerability was excellent (55.9%), moderate (41.2%) and poor (2.9%).
Conclusion: CT guided cervical epidural injections appear effective and well-tolerated. A blinded randomized study could validate its value. However, a study comparing steroids and placebo raises ethical concerns.