title: Immediate pain response does not predict long-term outcome of CT-guided cervical transforaminal epidural steroid injections.
abstract: OBJECTIVE
  Imaging-guided cervical transforaminal epidural steroid injections have been shown to decrease verbal numerical pain scores and improve functionality (Roland Morris Disability Index). These injections are often administered in combination with local anesthetic. The purpose of this study was to determine if the immediate postprocedure VNPS predicts the long-term effectiveness of the injection.
  
  
  METHODS
  A quality assurance data base review of 247 patient records was used to document the VNPS and RMDI of patients undergoing a single CT-guided CTESI. Pain scores were recorded before the procedure, immediately after the procedure, at 2 weeks, and at 2 months. The RMDI was recorded before the procedure, at 2 weeks, and at 2 months. Spearman rank correlation analysis and logistic regression models were used to determine if the immediate postprocedure or 2-week VNPS correlated with or predicted the longer-term VNPS and RMDI as measured at 2 weeks and 2 months.
  
  
  RESULTS
  There was not a strong correlation between the pain score obtained immediately after the procedure and the 2-month outcome of the VNPS or RMDI. The pain scores at 2 weeks did correlate with the 2-month outcomes. The 2-week VNPS also was a significant predictor of patients who would achieve a >50% improvement in VNPS or RMDI at 2 months.
  
  
  CONCLUSIONS
  Pain scores obtained immediately after completion of a single CT-guided CTESI do not predict the long-term effectiveness of this procedure. However, patient response at 2 weeks does correlate with the long-term effectiveness of these injections as measured by the VNPS and the RMDI.
authors: Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA. wald.john2@mayo.edu
authors: J T
authors: JT
authors: Wald
authors: T P
authors: TP
authors: Maus
authors: J R
authors: JR
authors: Geske
authors: F E
authors: FE
authors: Diehn
authors: T J
authors: TJ
authors: Kaufmann
authors: N S
authors: NS
authors: Murthy
authors: K R
authors: KR
authors: Thielen
authors: S
authors: S
authors: Watson
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D010147:Pain Measurement / Q000187:drug effects* / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D015641:Radiography, Interventional / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013256:Steroids / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D016896:Treatment Outcome
chemical_list: D013256:Steroids