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01-01-2014 | Anesthetic Techniques in Pain Management (D Wang, Section Editor)

Cervical Radicular Pain: The Role of Interlaminar and Transforaminal Epidural Injections

Authors: Laxmaiah Manchikanti, Frank J. E. Falco, Sudhir Diwan, Joshua A. Hirsch, Howard S. Smith

Published in: Current Pain and Headache Reports | Issue 1/2014

Abstract

Chronic neck pain and cervical radicular pain are relatively common in the adult population. Treatment for chronic radicular pain recalcitrant to conservative management includes surgical management as well as interventional techniques with epidural injections utilizing either an interlaminar approach or transforaminal approach. Although there have been multiple systematic reviews and randomized clinical trials of cervical interlaminar epidural injections, the literature is sparse in reference to cervical transforaminal epidural injections. Overall, there is good evidence for the effectiveness of cervical interlaminar epidural injections in managing cervical disc herniation and fair evidence in managing central spinal stenosis and postsurgery syndrome. The evidence is poor, however, for cervical transforaminal epidural injections. Complications with cervical interlaminar epidural injections are rare, but more commonly occur with transforaminal epidural injections and can be fatal. Emerging concepts in pain include further randomized trials; proper placebo design; focus on control design (either active control or placebo control); and appropriate methodologic quality assessment and evidence synthesis.

Côté P, Cassidy JD, Carroll L. The Saskatchewan Health and Back Pain Survey. The prevalence of neck pain and related disability in Saskatchewan adults. Spine. 1998;23:1689–98.

Bogduk N. Medical Management of Acute Cervical Radicular Pain: an evidence-based approach. 1st ed. Newcastler: Cambridge Press; 1999.

Bogduk N. Pathology. In: Medical Management of Acute Cervical Radicular Pain: an evidence-based approach. 1st Ed. Newcastle, Cambridge Press; 1999; pp 13–8.

Karadimas SK, Klironomos G, Papachristou DJ, Papanikolaou S, Papadaki E, Gatzounis G. Immunohistochemical profile of NF-κB/p50, NF-κB/p65, MMP-9, MMP-2, and u-PA in experimental cervical spondylotic myelopathy. Spine. 2013;38:4–10.PubMed

Park MS, Moon SH, Lee HM, Kim SW, Kim TH, Suh BK, et al. The natural history of degenerative spondylolisthesis of the cervical spine with 2- to 7-year follow-up. Spine. 2013;38:E205–10. Spine. 2013;38:4–10.

Kang JD, Georgescu HI, McIntyre-Larkin L, Stefanovic-Racic M, Evans CH. Herniated cervical intervertebral discs spontaneously produce matrix metalloproteinases, nitric oxide, interleukin-6 and prostaglandin E2. Spine. 1995;20:2373–8.PubMed

Radhakrishnan K, Litchy WJ, O’Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117(Pt2):325–35.PubMed

Boselie TF, Willems PC, van Mameren H, de Bie RA, Benzel EC, van Santbrink H. Arthroplasty vs fusion in single-level cervical degenerative disc disease: a Cochrane Review. Spine. 2013;38(17):E1096–107.PubMed

•• Manchikanti L, Abdi S, Atluri S, Benyamin RM, Boswell MV, Buenaventura RM, et al. An update of comprehensive evidence-based guidelines for interventional techniques of chronic spinal pain: Part II: guidance and recommendations. Pain Physician. 2013;16(2S):S49–S283. These comprehensive guidelines are based on evidence-based medicine principles with assessment of methodologic quality of manuscripts along with review of wide array of literature available with extensive references.PubMed

10.

•• Diwan SA, Manchikanti L, Benyamin RM, Bryce DA, Geffert S, Hameed H, et al. Effectiveness of cervical epidural injections in the management of chronic neck and upper extremity pain. Pain Physician. 2012;15:E405–34. This systematic review describes the effectiveness of interlaminar epidural injections in managing chronic neck and radicular pain. Authors have utilized extensive methodologic assessment of the manuscripts and synthesized the evidence-based on all available evidence.PubMed

11.

Manchikanti L, Falco FJE, Singh V, Pampati V, Parr AT, Benyamin RM, et al. Utilization of interventional techniques in managing chronic pain in the Medicare population: analysis of growth patterns from 2000 to 2011. Pain Physician. 2012;15:E969–82.PubMed

12.

Manchikanti L, Pampati V, Falco FJE, Hirsch JA. Growth of spinal interventional pain management techniques: analysis of utilization trends and Medicare expenditures 2000 to 2008. Spine. 2013;38:157–68.PubMed

13.

•• Manchikanti L, Pampati V, Falco FJE, Hirsch JA. Assessment of the growth of epidural injections in the Medicare population from 2000 to 2011. Pain Physician. 2013;16:E349–64. This manuscript shows growth of epidural injections specifically cervical interlaminar and transforaminal epidural injections which are escalating despite multitude of complications.PubMed

14.

Manchikanti L, Pampati V, Singh V, Falco FJE. Assessment of the escalating growth of facet joint interventions in the Medicare population in the United States from 2000 to 2011. Pain Physician. 2013;16:E365–78.PubMed

15.

Stout A. Epidural steroid injections for cervical radiculopathy. Phys Med Rehabil Clin N Am. 2011;22:149–59.PubMed

16.

Huston CW. Cervical epidural steroid injections in the management of cervical radiculitis: interlaminar vs transforaminal. A review. Curr Rev Musculoskelet Med. 2009;2:30–42.PubMedCentralPubMed

17.

Candido KD, Knezevic N. Cervical epidural steroid injections for the treatment of cervical spinal (neck) pain. Curr Pain Headache Rep. 2013;17:314.PubMed

18.

Manchikanti L, Cash KA, Pampati V, Malla Y. Fluoroscopic cervical epidural injections in chronic axial or disc-related neck pain without disc herniation, facet joint pain, or radiculitis. J Pain Res. 2012;5:227–36.PubMedCentralPubMed

19.

Manchikanti L, Malla Y, Cash KA, McManus CD, Pampati V. Fluoroscopic cervical interlaminar epidural injections in managing chronic pain of cervical post-surgery syndrome: preliminary results of a randomized, double-blind active control trial. Pain Physician. 2012;15:13–26.PubMed

20.

•• Manchikanti L, Cash KA, Pampati V, Wargo BW, Malla Y. Management of chronic pain of cervical disc herniation and radiculitis with fluoroscopic cervical interlaminar epidural injections. Int J Med Sci. 2012;9:424–34. The first double-blind randomized, active control trial performed under fluoroscopy in contemporary interventional pain management setting, showing positive results in disc herniation.PubMedCentralPubMed

21.

Stav A, Ovadia L, Sternberg A, Kaadan M, Weksler N. Cervical epidural steroid injection for cervicobrachialgia. Acta Anaesthesiol Scand. 1993;37:562–6.PubMed

22.

Castagnera L, Maurette P, Pointillart V, Vital JM, Erny P, Senegas J. Long-term results of cervical epidural steroid injection with and without morphine in chronic cervical radicular pain. Pain. 1994;58:239–43.PubMed

23.

Pasqualucci A, Varrassi G, Braschi A, Peduto VA, Brunelli A, Marinangeli F, et al. Epidural local anesthetic plus corticosteroid for the treatment of cervical brachial radicular pain: single injection vs continuous infusion. Clin J Pain. 2007;23:551–7.PubMed

24.

Manchikanti L, Malla Y, Cash KA, McManus CD, Pampati V. Fluoroscopic epidural injections in cervical spinal stenosis: preliminary results of a randomized, double-blind, active control trial. Pain Physician. 2012;15:E59–70.PubMed

25.

Lee SH, Kim KT, Kim DH, Lee BJ, Son ES, Kwack YH. Clinical outcomes of cervical radiculopathy following epidural steroid injection: a prospective study with follow-up for more than 2 years. Spine. 2012;37:1041–7.PubMed

26.

Kranz PG, Raduazo PA. Technique for CT fluoroscopy-guided cervical interlaminar steroid injections. Am J Roentgenol. 2012;198:675–7.

27.

Usta B, Muslu B, Demircioğlu RI, Sert H, Gözdemir M, Karabayirli S. Cervical epidural steroid injections for symptomatic disc herniations. Agri. 2012;24:130–4.PubMed

28.

Beyaz SG, Eman A. Fluoroscopy guided cervical interlaminar steroid injections in patients with cervical pain syndromes: a retrospective study. J Back Musculoskelet Rehabil. 2013;26:85–91.PubMed

29.

Shakir A, Ma V, Mehta B. Prediction of therapeutic response to cervical epidural steroid injection according to distribution of radicular pain. Am J Phys Med Rehabil. 2011;90:917–22.PubMed

30.

Schultz DM, Manchikanti L, Racz GB. Cervical transforaminal epidural injections. In: Manchikanti L, Singh V, editors. Interventional Techniques in Chronic Spinal Pain. Paducah, KY: ASIPP Publishing; 2007. p. 455–78.

31.

Datta S, Everett CR, Trescot AM, Schultz DM, Adlaka R, Abdi S, et al. An updated systematic review of diagnostic utility of selective nerve root blocks. Pain Physician. 2007;10:113–28.PubMed

32.

Anderberg L, Annertz M, Rydholm U, Brandt L, Säveland H. Selective diagnostic nerve root block for the evaluation of radicular pain in the multilevel degenerated cervical spine. Eur Spine J. 2006;15:794–801.PubMedCentralPubMed

33.

Manchikanti L, Malla Y, Wargo BW, Cash KA, Pampati V, Fellows B. A prospective evaluation of complications of 10,000 fluoroscopically directed epidural injections. Pain Physician. 2012;15:131–40.PubMed

34.

Abbasi A, Malhotra G, Malanga G, Elovic EP, Kahn S. Complications of interlaminar cervical epidural steroid injections: a review of the literature. Spine. 2007;32:2144–51.PubMed

35.

• Scanlon GC, Moeller-Bertram T, Romanowsky SM, Wallace MS. Cervical transforaminal epidural steroid injections: more dangerous than we think? Spine. 2007;32:1249–56. This manuscript provides extensive description of complications related to cervical transforaminal epidural injections.PubMed

36.

Hodges SD, Castleberg RL, Miller T, Ward R, Thornburg C. Cervical epidural steroid injection with intrinsic spinal cord damage. Two case reports. Spine. 1998;23:2137–42.PubMed

37.

Bose B. Quadriparesis following cervical epidural steroid injections: case report and review of the literature. Spine J. 2005;5:558–63.PubMed

38.

Beckworth WJ, Dreyer S. Safety considerations in epidural steroid injections: particulate vs nonparticulate steroids. North American Spine Society SpineLine OnLine. http://www.spine.org/Pages/Publications/SpineLine/CurveSurvey/Archives/cc_sle09mayjun.aspx.

39.

Kaplan MS, Cunniff J, Cooke J, Collins JG. Intravascular uptake during fluoroscopically guided cervical interlaminar steroid injection at C6-7: a case report. Arch Phys Med Rehabil. 2008;89:553–8.PubMed

40.

McGrath JM, Schaefer MP, Malkamaki DM. Incidence and characteristics of complications from epidural steroid injections. Pain Med. 2011;12:726–31.PubMed

41.

Shanthanna H, Park J. Acute epidural haematoma following epidural steroid injection in a patient with spinal stenosis. Anaesthesia. 2011;66:837–9.PubMed

42.

Singh R, Panagos A. Quadriparesis following cervical epidural steroid injections. Spine J. 2006;6:349.PubMed

43.

Rathmel JP, Benzon HT. Transforaminal injection of steroids: should we continue? Reg Anesth Pain Med. 2004;29:297–9.

44.

Tiso RL, Cutler T, Catania JA, Whalen K. Adverse central nervous system sequelae after selective transforaminal block: the role of corticosteroids. Spine J. 2004;4:468–74.PubMed

45.

Ludwig MA, Burns SP. Spinal cord infarction following cervical transforaminalepidural injection: a case report. Spine. 2005;30:E266–8.PubMed

46.

Brouwers PJ, Kottink EJ, Simon MA, Prevo RL. A cervical anterior spinal artery syndrome after diagnostic blockade of the right C6-nerve root. Pain. 2001;91:397–9.PubMed

47.

Wallace MA, Fukui MB, William RL, Ku A, Baghai P. Complications of cervical selective nerve root blocks performed with fluoroscopic guidance. Am J Roentgenol. 2007;188:1218–21.

48.

Rathmell JP, Aprill C, Bogduk N. Cervical transforaminal injection of steroids. Anesthesiology. 2004;100:1595–600.PubMed

49.

Tripathi M, Nath SS, Gupta RK. Paraplegia after intracord injection during attempted epidural steroid injection in an awake-patient. Anesth Analg. 2005;101:1209–11.PubMed

50.

Provenzano DA, Fanciullo G. Cervical transforaminal epidural steroid injections: should we be performing them? Reg Anesth Pain Med. 2007;32:168. author reply 169–70.PubMed

51.

Cluff R, Mehio AK, Cohen SP, Chang Y, Sang CN, Stojanovic MP. The technical aspects of epidural steroid injections: a national survey. Anesth Analg. 2002;95:403–8.PubMed

52.

Stojanovic MP, Vu TN, Caneris O, Slezak J, Cohen SP, Sang CN. The role of fluoroscopy in cervical epidural steroid injections: an analysis of contrast dispersal patterns. Spine. 2002;27:509–14.PubMed

53.

Kim KS, Shin SS, Kim TS, Jeong CY, Yoon MH, Choi JI. Fluoroscopically guided cervical interlaminar epidural injections using the midline approach: an analysis of epidurography contrast patterns. Anesth Analg. 2009;108:1658–61.PubMed

54.

Goel A, Pollan JJ. Contrast flow characteristics in the cervical epidural space: an analysis of cervical epidurograms. Spine. 2006;31:1576–9.PubMed

55.

Ho PS, Yu SW, Sether LA, Wagner M, Ho KC, Haughton VM. Ligamentum flavum: appearance on sagittal and coronal MR images. Radiology. 1988;168:469–72.PubMed

56.

Lirk P, Kolbitsch C, Putz G, Colvin J, Colvin HP, Lorenz I, et al. Cervical and high thoracic ligamentum flavum frequently fails to fuse in the midline. Anesthesiology. 2003;99:1387–90.PubMed

57.

Datta S, Manchikanti L, Falco FJE, Calodney AK, Atluri S, Benyamin RM, et al. Diagnostic utility of selective nerve root blocks in the diagnosis of lumbosacral radicular pain: systematic review and update of current evidence. Pain Physician. 2013;16(2 Suppl):SE97–SE124.PubMed

58.

Manchikanti L, Buenaventura RM, Manchikanti KN, Ruan X, Gupta S, Smith HS, et al. Effectiveness of therapeutic lumbar transforaminal epidural steroid injections in managing lumbar spinal pain. Pain Physician. 2012;15:E199–245.PubMed

59.

Bush K, Hillier S. Outcome of cervical radiculopathy treated with peri-radicular/epidural corticosteroid injections: a prospective study with independent clinical review. Eur Spine J. 1996;5:319–25.PubMed

60.

Kolstad F, Leivseth G, Nygaard OP. Transforaminal steroid injections in the treatment of cervical radiculopathy. A prospective outcome study. Acta Neurochir. 2005;147:1065–70.PubMed

61.

Cyteval C, Thomas E, Decoux E, Sarrabere MP, Cottin A, Blotman F, et al. Cervical radiculopathy: open study on percutaneous periradicular foraminal steroid infiltration performed under CT control in 30 patients. Am J Neuroradiol. 2004;25:441–5.PubMed

62.

Lin EL, Lieu V, Halevi L, Shamie AN, Wang JC. Cervical epidural steroid injections for symptomatic disc herniations. J Spinal Disord Tech. 2006;19:183–6.PubMed

63.

Persson L, Anderberg L. Repetitive transforaminal steroid injections in cervical radiculopathy: a prospective outcome study including 140 patients. Evid Based Spine Care J. 2012;3:13–20.PubMedCentralPubMed

64.

Wald JT, Maus TP, Geske JR, Carter RE, Diehn FE, Kaufmann TJ, et al. Safety and efficacy of CT-guided transforaminal cervical epidural steroid injections using a posterior approach. Am J Neuroradiol. 2012;33:415–9.PubMed

65.

Chung JY, Yim JH, Seo HY, Kim SK, Cho KJ. The efficacy and persistence of selective nerve root block under fluoroscopic guidance for cervical radiculopathy. Asian Spine J. 2012;6:227–32.PubMedCentralPubMed

66.

Slipman CW, Lipetz JS, DePalma MJ, Jackson HB. Therapeutic selective nerve root block in the nonsurgical treatment of traumatically induced cervical spondylotic radicular pain. Am J Phys Med Rehabil. 2004;83:446–54.PubMed

67.

Slipman CW, Lipetz JS, Jackson HB, Rogers DP, Vresilovic EJ. Therapeutic selective nerve root block in the nonsurgical treatment of atraumatic cervical spondylotic radicular pain: a retrospective analysis with independent clinical review. Arch Phys Med Rehabil. 2000;81:741–6.PubMed

68.

Ho KY. Vascular uptake of contrast despite negative aspiration in interlaminar cervical epidural injection. Pain Physician. 2006;9:267–8.PubMed

69.

Botwin KP, Castellanos R, Rao S, Hanna AF, Torres-Ramos FM, Gruber RD, et al. Complications of fluoroscopically guided interlaminar cervical epidural injections. Arch Phys Med Rehabil. 2003;84:627–33.PubMed

70.

Manchikanti L, Benyamin RM, Swicegood JR, Falco FJE, Datta S, Pampati V, et al. Assessment of practice patterns of perioperative management of antiplatelet and anticoagulant therapy in interventional pain management. Pain Physician. 2012;15:E955–68.PubMed

71.

Stauber B, Ma L, Nazari R. Cardiopulmonary arrest following cervical epidural injection. Pain Physician. 2012;15:147–52.PubMed

72.

Reitman CA, Watters III W. Subdural hematoma after cervical epidural steroid injection. Spine. 2002;27:E174–6.PubMed

73.

Markewich S, Wunnava M. Unclear mechanism of cardiopulmonary arrest following cervical epidural steroid injection. Pain Physician. 2012;15:E539–40.PubMed

74.

Manchikanti L, Falco FJE, Benyamin RM, Caraway DL, Kaye AD, Helm II S, et al. Assessment of bleeding risk of interventional techniques: a best evidence synthesis of practice patterns and perioperative management of anticoagulant and antithrombotic therapy. Pain Physician. 2013;16(2 Suppl):SE261–318.PubMed

75.

Mehta S, Khalil AA, Alshekhlee A. Air myelopathy following a cervical epidural injection. Pain Med. 2010;11:1678–9.PubMed

76.

Williams KN, Jackowski A, Evans PJ. Epidural haematoma requiring surgical decompression following repeated cervical epidural steroid injections for chronic pain. Pain. 1990;42:197–9.PubMed

77.

Dietrich CL, Smith CE. Epidural granuloma and intracranial hypotension resulting from cervical epidural steroid injection. Anesthesiology. 2004;100:445–7.PubMed

78.

Huang RC, Shapiro GS, Lim M, Sandhu HS, Lutz GE, Herzog RJ. Cervical epidural abscess after epidural steroid injection. Spine. 2004;29:E7–9.PubMed

79.

Ziai WC, Ardelt AA, Llinas RH. Brainstem stroke following uncomplicated cervical epidural steroid injection. Arch Neurol. 2006;63:1643–6.PubMed

80.

Furman MB, Giovanniollo MT, O’Brien EM. Incidence of intravascular penetration in transforaminal cervical epidural steroid injections. Spine. 2003;28:21–5.PubMed

81.

Derby R, Lee S, Kim B, Chen Y, Seo KS. Complications following cervical epidural steroid injections by expert interventionalists in 2003. Pain Physician. 2004;7:445–9.PubMed

82.

Beckman WA, Mendez RJ, Paine GF, Mazzilli MA. Cerebellar herniation after cervical transforaminal epidural injection. Reg Anesth Pain Med. 2006;31:282–5.PubMed

83.

Rozin L, Rozin R, Koehler SA, Shakir A, Ladham S, Barmada M, et al. Death during transforaminal epidural steroid nerve root block (C7) due to perforation of the left vertebral artery. Am J Forensic Med Pathol. 2003;24:351–5.PubMed

84.

Karasek M, Bogduk N. Temporary neurologic deficit after cervical transforaminal injection of local anesthetic. Pain Med. 2004;5:202–5.PubMed

85.

Huntoon MA, Martin DP. Paralysis after transforaminal epidural injection and previous spinal surgery. Reg Anesth Pain Med. 2004;29:494–5.PubMed

86.

Tofuku K, Koga H, Komiya S. Subdural spread of injected local anesthetic in a selective transforaminal cervical nerve root block: a case report. J Med Case Rep. 2012;6:142.PubMedCentralPubMed

87.

Verrills P, Nowesenitz G, Barnard A. Penetration of a cervical radicular artery during a transforaminal epidural injection. Pain Med. 2010;11:229–31.PubMed

88.

Pobiel RS, Schellhas KP, Eklund JA, Golden MJ, Johnson BA, Chopra S, et al. Selective cervical nerve root blockade: prospective study of immediate and longer term complications. Am J Neuroradiol. 2009;30:507–11.PubMed

89.

Ma DJ, Gilula LA, Riew KD. Complications of fluoroscopically guided extraforaminal cervical nerve blocks. An analysis of 1036 injections. J Bone Joint Surg Am. 2005;87:1025–30.PubMed

90.

Glaser SE, Falco F. Paraplegia following a thoraco lumbar transforaminal epidural steroid injection. Pain Physician. 2005;8:309–14.PubMed

91.

Atluri S, Glaser SE, Shah RV, Sudarsha G. Needle position analysis in cases of paralysis from transforaminal epidurals: consider alternative approaches to traditional techniques. Pain Physician. 2013;16:321–34.PubMed

92.

Huntoon MA. Anatomy of the cervical intervertebral foramina: vulnerable arteries and ischemic neurologic injuries after transforaminal epidural injections. Pain. 2005;117:104–11.PubMed

93.

Hoeft MA, Rathmell JP, Monsey RD, Fonda BJ. Cervical transforaminal injection and the radicular artery: variation in anatomical location within the cervical intervertebral foramina. Reg Anesth Pain Med. 2006;31:270–4.PubMed

94.

Beckworth WJ, Sood R, Katzer AF, Wu B. Anomalous location of the vertebral artery in relation to the neural foramen. Implications for cervical transforaminal epidural steroid injections. Pain Med. 2013.

95.

Cousins MJ. An additional dimension to the efficacy of epidural steroids. Anesthesiology. 2000;93:565.PubMed

96.

Manchikanti L, Singh V. Corticosteroids. In: Manchikanti L, Christo PJ, Trescot AM, Falco FJE, editors. Foundations of Pain Medicine and Interventional Pain Management: a comprehensive review. Paducah, KY: ASIPP Publishing; 2011. p. 589–606.

97.

Derby R. Point of view: cervical epidural steroid injection with intrinsic spinal cord damage: 2 case reports. Spine. 1998;23:2141–2.

98.

Goodman B, Petalcorin JS, Mallempati S. Optimizing patient positioning and fluoroscopic imaging for the performance of cervical interlaminar epidural steroid injections. PMR. 2010;2:783–6.

99.

Hoang JK, Massoglia DP, Apostol MA, Lascola CD, Eastwood JD, Kranz PG. CT-guided cervical transforaminal steroid injections: where should the needle tip be located? Am J Neuroradiol. 2013;34:688–92.PubMed

100.

Hoang JK, Apostol MA, Kranz PG, Kilani RK, Taylor JN, Gray L, et al. CT fluoroscopy-assisted cervical transforaminal steroid injection: tips, traps, and use of contrast material. Am J Roentgenol. 2010;195:888–94.

101.

Cho CH. Cervical nerve injection: computed tomography guidance with intravenous contrast and extraforaminal needle placement. Series of seven consecutive case reports. Spine J. 2010;10:e1–6.PubMed

102.

Wolter T, Mohadjer M, Berlis A, Knoeller S. Cervical CT-guided, selective nerve root blocks: improved safety by dorsal approach. Am J Neuroradiol. 2009;30:336–7.PubMed

103.

Morvan G, Mompoint D, Bard M, Levi-Valensin G. Direct intra-foraminal injection of corticosteroids in the treatment of cervico-brachial pain. In: Bard M, Laredo J, editors. Interventional Radiology in Bone and Joint. New York, NY: Springer-Verlag; 1988. p. 253–7.

104.

Vallee JN, Feydy A, Carlier RY, Mutschler C, Mompoint D, Vallee CA. Chronic cervical radiculopathy: lateral approach periradicular corticosteroid injection. Radiology. 2001;218:886–92.PubMed

105.

Kloth DS, Calodney AK, Derby R, Lagattuta FP, O'Neill C, Yurth E, et al. Improving the safety of transforaminal epidural steroid injections in the treatment of cervical radiculopathy. Pain Physician. 2011;14:285–93.PubMed

106.

Smuck M, Leung D. Inadvertent injection of a cervical radicular artery using an atraumatic pencil-point needle. Spine. 2011;36:E220–3.PubMed

107.

Depriester C, Setbon S, Larde A, Malaquin E, Vanden Abeele B, Bocquet J. CT-guided transforaminal cervical and lumbar epidural injections. Diagn Interv Imaging. 2012;93:704–10.PubMed

108.

Kranz PG, Raduazo P, Gray L, Kilani RK, Hoang JK. CT fluoroscopy-guided cervical interlaminar steroid injections: safety, technique, and radiation dose parameters. Am J Neuroradiol. 2012;33:1221–4.PubMed

109.

Gilula LA, Ma D. A cervical nerve block approach to improve safety. Am J Roentgenol. 2007;189:563–5.

110.

Schellhas KP, Pollei SR, Johnson BA, Golden MJ, Eklund JA, Pobiel RS. Selective cervical nerve root blockade: experience with a safe and reliable technique using an anterolateral approach for needle placement. Am J Neuroradiol. 2007;28:1909–14.PubMed

111.

Lee SH, Kim JM, Chan V, Kim HJ, Kim HI. Ultrasound-guided cervical periradicular steroid injection for cervical radicular pain: relevance of spread pattern and degree of penetration of contrast medium. Pain Med. 2013;14:5–13.PubMed

112.

Baker R, Dreyfuss P, Mercer S, Bogduk N. Cervical transforaminal injection of corticosteroids into a radicular artery: a possible mechanism for spinal cord injury. Pain. 2003;103:211–5.PubMed

113.

Dreyfuss P, Baker R, Bogduk N. Comparative effectiveness of cervical transforaminal injections with particulate and nonparticulate corticosteroid preparations for cervical radicular pain. Pain Med. 2006;7:237–42.PubMed

114.

Wagner AL. CT fluoroscopic-guided cervical nerve root blocks. Am J Neuroradiol. 2005;26:43–4.PubMed

115.

Bogduk N. Cervical transforaminal injection of corticosteroids. In: Practice Guidelines for Spinal Diagnostic and Treatment Procedures. 1st ed. San Francisco: International Spine Intervention Society; 2004; pp 237–48.

116.

Windsor RE, Storm S, Sugar S, Nagula D. Cervical transforaminal injection: review of the literature, complications, and a suggested technique. Pain Physician. 2003;6:457–65.PubMed

117.

Manchikanti L, Giordano J, Fellows B, Hirsch JA. Placebo and nocebo in interventional pain management: a friend or a foe - or simply foes? Pain Physician. 2011;14:E157–75.PubMed

118.

Howick J, Bishop FL, Heneghan, Wolstenholme J, Stevens S, Hobbs FDR, et al. Placebo use in the United Kingdom: results from a national survey of primary care practitioners. PLoS One. 2013;8:e58247.PubMedCentralPubMed

119.

Howick J, Friedemann C, Tsakok M, Watson R, Tsakok T, Thomas J, et al. Are treatments more effective than placebos? A systematic review and meta-analysis. PLoS One. 2013;8:e62599.PubMedCentralPubMed

120.

Hróbjartsson A, Gøtzsche PC. Placebo interventions for all clinical conditions. Cochrane Database Syst Rev. 2010;1, CD003974.PubMed

Title: Cervical Radicular Pain: The Role of Interlaminar and Transforaminal Epidural Injections
Authors: Laxmaiah Manchikanti
Frank J. E. Falco
Sudhir Diwan
Joshua A. Hirsch
Howard S. Smith
Publication date: 01-01-2014
Publisher: Springer US
Published in: Current Pain and Headache Reports / Issue 1/2014
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI: https://doi.org/10.1007/s11916-013-0389-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cervical Radicular Pain: The Role of Interlaminar and Transforaminal Epidural Injections

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Keynote webinar | Spotlight on medication adherence

Springer Medicine

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