INTERLAMINAR CERVICAL EPIDURAL INJECTIONS OF STEROIDS PLUS LOCAL ANESTHETICS IN PATIENTS WITH CERVICAL RADICULOPATHY

Transforaminal epidural injections have the advantage of being able to place medication directly around the dorsal root ganglion pathologically involved in causing a patient’s radicular pain. Medication in the epidural space will tend to flow in the direction of least resistance. With interlaminar paramedian cervical epidural injections, the medication tends to spread unilateral in 51% and ventral in only 28%. Method: Forty patients received cervical epidural injection after failure of conservative treatment. They were divided into two equal groups: First group: twenty patients received cervical epidural injections using a combination of corticosteroids and local anesthetic. Dose: 1.0 cc of 1% lidocaine with 2.0 cc of dexamethsone 4mg/ ml for a total volume of 3.0 cc. Second group: twenty patients received cervical epidural injections using local anesthetic only: Dose: 1.0 cc of 1% lidocaine with 2.0 ml normal saline to increase total volume to 3 ml. Result: There was statistically significant increase of VAS (after-before) in group A in comparison to group B (5.49±0.82 vs 3.65±1.18 respectively). Conclusion: According to results of the present study, using a single injection for the treatment of cervical radiculopathy presenting with radicular pain, the combination of steroids and local anesthetics did provide more symptom reduction than the local anesthetics.