Objective: To assess long-term results of a single cervical epidural corticosteroid injection (CECI) in patients suffering from chronic cervicobrachial neuralgia (CCBN).
Study design: Open prospective study.
Patients: A CECI was performed in 29 patients suffering for more than 12 months from a non-compressive and non-surgical CCBN with permanent pain for at least three months non relieved by an adequately conducted medical treatment.
Methods: The cervical epidural space was injected (C7-T1, 18 G needle) with an increasing volume (maximum 10 mL) of isotonic saline solution to exacerbate patient's cervicobrachial pain. The patients then received an equivalent volume of 0.5% lidocaine plus triamcinolone acetonide (10 mg.mL-1). The pain decrease was estimated on a visual analogic scale (VAS), in comparison to intensity of pain rated at 100 mm before CECI.
Results: The mean volume injected into the epidural space was 6 +/- 2 mL. It increased pain in 26 out of 29 patients. After 3 months, a success rate of 83% was obtained, with a pain rate of 12 mm on VAS. Concerning mid- and long-term results, pain relief remained stable for at least 24 months (mean follow-up: 48 +/- 18 months). Simultaneously, the need for analgesics decreased significantly.
Conclusion: A single CECI in patients suffering from non-compressive and non-surgical CCBN results in long-lasting pain relief.