Neck Pain Treatment Safer Without Significant Risk of Paralysis
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In the largest series of patients to date, recent research shows that the translaminar approach to cervical spinal steroid injections can reduce neck pain in eighty-three percent of those treated. In addition to being an effective treatment, the translaminar approach was found to be safer than an alternative method or surgery, as no major complications were observed. In the alternative approach, steroids are injected in close proximity to nerve bundles and small blood vessels in the spine, which can result in nerve damage or paralysis. The translaminar technique in the study avoids this risk by injecting the steroids into the epidural space in the neck, allowing the drug to spread up and down the spine to reduce the inflammation and subsequently reduce pain. This safer translaminar approach is an outpatient treatment, requiring only a small amount of local anesthesia. Although the injection does not treat the underlying cause of the pain, such as arthritis or herniated disc, it does treat the immediate pain flare-up, allowing patients to get back to their normal routines. The research was presented today at the Society of Interventional Radiology’s 32nd Annual Scientific Meeting in Seattle.
“Although the other approach offers pain relief, there is increased risk of major complications such as paralysis. This study shows the translaminar approach is just as effective, but without the risk,” explained lead researcher William M. Strub, M.D., of the University of Cincinnati, who completed the study with interventional radiologists based at The Christ Hospital. “This procedure can help provide pain relief in patients with neck pain from bulging discs, arthritis, and even in patients who continue to have pain after cervical spine surgery. It’s well tolerated, outpatient, nonsurgical, safe and effective, and as such, we expect this approach to become the gold standard for reducing patients’ neck pain.”
The neck pain treated by these steroid injections was due to aging of the spine. This includes degenerative changes such as osteoarthritis of the spine, bone spurs, disc degeneration and narrowing of the spinal canal. Additional alternative treatments for neck pain are physical therapy, traction, narcotic and non-narcotic pain medication and, in some cases, surgery.
During the procedure, an interventional radiologist utilizes real-time, continuous X-ray imaging to guide a small needle into the base of the neck between the C7 and T1 vertebrae, the largest epidural space in the neck, and injects a small amount of medication. The medication then spreads up and down the spine to reduce the inflammation in the spine, reducing pain. The patient is kept awake to enable communication with the physician, but the skin is numbed. After a brief observation period, the patient is released the same day. Patients receive between one and three injection treatments with approximately three to four weeks between the procedures. Typically, patients who will be the most responsive to the translaminar injection will notice the greatest amount of pain reduction after the first treatment. The translaminar steroid injection is ideal for patients who are not receiving adequate relief from over-the-counter pain medications, but who are not ready for spine surgery.
Source: Society of Interventional Radiology (SIR)
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