Korean J Pain.  2007 Jun;20(1):46-49. 10.3344/kjp.2007.20.1.46.

A Comparison of the Spread Level of the Cervical Epidural Block in Terms of Volume

• Jo DH
• Kim MH
• Ahn SY
• Park SH
• Lee KC

• KMID: 2278039
• DOI: http://doi.org/10.3344/kjp.2007.20.1.46

Abstract

BACKGROUND: Cervical epidural injection, performed via the interlaminar approach, represents a useful interventional pain management procedure indicated in patients with a cervical herniated disk. Due to thedecreased epidural space in the cervical region, cervical epidural injections may result in potentially serious complications, especially during a large volume injection.
METHODS
Thirty-four patients with neck pain due to a cervical herniated disk that were referred to the pain clinic for cervical epidural steroid injection were randomized into two groups. One group received a cervical epidural injection of 4 ml drug and the other group received 2 ml drug. The injected mixture included triamcinolon, ropivacaine and omnipaque. Spread levels of the drug after injection were estimated with the use of C-arm fluoroscopy.
RESULTS
Spread levels to the cephalad for patients in the two groups were 4.88 +/- 0.78 segments and 4.53 +/- 0.49 segments, respectively. Spread levels to the caudad for patients in the two groups were 4.59 +/- 0.93 segments and 4.47 +/- 0.51 segments, respectively. The results showed no significant difference in the spread level between the two groups.
CONCLUSIONS
Use of a small volume of drug (2 ml) can provide a sufficient spread level of the injected drug that is desirable for patients with a cervical herniated disk.

Keyword

cervical epidural steroid injection; cervical herniated disk; drug spread level

MeSH Terms

Epidural Space
Fluoroscopy
Humans
Injections, Epidural
Intervertebral Disc Displacement
Iohexol
Neck Pain
Pain Clinics
Pain Management
Iohexol