Devoted to diagnostic and interventional spine imaging and therapeutics

Library

CT Guided steroid injection for spine pain syndromes 2009

Interventional Spine

Todd S Miller, MD,
Joaquim Farinhas, MD, Non ASSR Member
Allan L Brook, MD, ASSR Member
Mark Ashkan, BS, Non ASSR Member

Scientific Paper

Mentor Award: Yes

Institution where work was conducted

Montefiore Medical Center

Affiliation and Department

Albert Einstein College of Medicine, Radiology

Address

111 East 210th Street
Bronx, New York
10463
Phone: 718-920-4030
Email: tmiller@montefiore.org

Purpose

The purpose of this study is to show safety and utility of CT guided steroid injections for spine pain syndromes.

Methods & Materials

This IRB approved study followed 277 consecutive patients (84M 193F Ave Age 61) from an out patient inner city interventional radiology practice for up to one year. All patients were referred from neurologists, rehabilitation specialists, orthopedists, or neurosurgeons for cervical (25), thoracic (15), or lumbar (237) pain syndromes. Visual Analogue Scale (VAS) scores and Roland Morris Disability (RMD) scores were used for patient assessment. All procedures were performed with CT scan guidance in an ambulatory surgery setting. All cervical injection locations were confirmed with 2cc contrast injections. All epidural injection (120) locations were confirmed with 2 cc air injections. In office or telephone followup was conducted.

Results

All procedures were technically successful. Average pre procedure (VAS 7 and RMD 11.9) scores improved (VAS 4.5 and RMD 4.9) at one year. Immediate VAS (2.75) increased over 12 hours to 2.9, continued to rise over the next 2 months (Average 59 days) to 4.5. There were no major complications. Minor complications included 5 (1.8%) vasovagal reactions, 10% with transient (<3 hours) leg numbness/weakness causing difficulty in ambulation, 2% lack of pain relief.

Conclusion

This study demonstrates the safety of CT guided steroid injections in an out patient setting. A demonstration of efficacy was not intended. There are no control subjects. These results will serve as a background for a clinical trial investigating the efficacy of CT guided steroid injections.