CT-guided epidural/perineural injections in painful disorders of the lumbar spine: short- and extended-term results.
OBJECTIVE
Evaluation of short- and extended-term results of repeated epidural/perineural injections (EDT/PRT) of corticoids in painful afflictions of the lumbar spine.


METHODS
Thirty-two patients who had persistent radicular or low back pain for more than 6 weeks were treated with CT-guided injection therapy. By EDT/PRT, 40 mg of triamcinolonacetonid was injected either periradicularly or by a direct intraspinal epidural method at intervals of 3 weeks. Altogether, 140 EDT/PRT were performed in 32 patients (mean 4.4, range 2-8). In nine patients partial facet joint denervation with 1-2 ml of 50% alcohol solution was combined with EDT/PRT to reduce low back pain. Before and after treatment and at follow-up (mean 9.6 months), treatment success was evaluated on a visual analog scale and by physical examination (good = >50% improvement, moderate = 20%-50%, no improvement = <20%).


RESULTS
Short-term (end of therapy) good or moderate improvement was achieved in 91% of patients, extended-term (mean 9.6 months) in 56%. Regarding certain subgroups, those with disc herniations of the lumbar spine showed a better outcome with good or moderate improvement in 95% short-term and 69% extended-term than those with spinal stenosis who had 72% short-term and 28% long-term.


CONCLUSIONS
Results indicate that CT-guided EDT/PRT in combination with partial facet joint denervation is a safe and effective outpatient treatment.
Schmid
G
G
Department of Diagnostic Radiology and Nuclear Medicine, St. Josef Hospital, University Hospital Bochum, Gudrunstrasse 56, D-44791 Bochum, Germany.
Vetter
S
S
Göttmann
D
D
Strecker
E P
EP
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007268:Injections, Epidural; D007278:Injections, Spinal; D007405:Intervertebral Disc Displacement / Q000188:drug therapy* / Q000503:physiopathology; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D013130:Spinal Stenosis / Q000188:drug therapy* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014221:Triamcinolone / Q000008:administration & dosage / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D014221:Triamcinolone