Cervical Transforaminal Injection of Steroids Guided by Ultrasound

Cervical Transforaminal Injection of Steroids Guided by Ultrasound

Cervical transforaminal epidural steroid injections (TFESI) are indicated in cervical radicular pain resistant to conservation therapy, by which steroids can be delivered into anterior epidural space surrounding target spinal nerve roots to help alleviate pain in the upper limb or neck. Cervical TFESI is traditionally commended to perform with guidance of fluoroscopy or CT. As fluoroscopy can not monitor the injection route whether it pass vessel or not, many serious neurological complications caused by inadvertent intra-arterial injection have been reported2. Here, the investigators will introduce a novel cervical TFESI guided by ultrasound, which incidence of inadvertent vessel injury or injection might be lower than those guided by fluoroscopy.

Inclusion Criteria:

• evidence of a cervical radiculopathy involving 1 spinal nerve of at least 1 month's duration refractory to medical treatment
• symptoms of cervical pain radiating to the upper limb
• and signs of altered sensations, ab- normal reflexes, or motor weakness caused by degenerative spondylosis and/or disk herniation as documented at CT or MR imaging and a current mean pain VAS score of six.

Exclusion criteria:

• evidence of vertebral fracture, tumor, or infection of the cervical spine
• treatment with cervical corticosteroid injections within the past 3 months
• coagulopathy
• allergy to iodinated contrast media.