CT guided Epidural Steroid Injection

Lim, Soo Mee; Lee, Choon Sung; Seo, Nieun; Chae, Eun Young; Suh, Dae Chul

Abstract

PURPOSE
CT guided epidural steroid injection (ESI) is not commonly used for the management of lumbar pain in Korea. Therefore, we evaluated a short term improvement as defined by the scale of pain after CT guided ESI.
MATERIALS AND METHODS
We prospectively followed 29 consecutive patients (average age, 62 years; range, 38-78 years; 10 men, 19 women) with lumbar radiculopathy for a minimal follow-up period of 1 month. The intensity of radicular pain was scored by the patient on the visual analog scan (VAS), from 0 (no pain) to 10 (maximal intensity). Scores before and after the procedure were compared by using the Wilcoxon signed-rank test for paired values. Pain relief was classified as "0" when the pain was completely resolved or had diminished, "1" for not changing, "2" for an increase in pain.
RESULTS
The mean VAS scores were 8 (range, 2-10) before and 5 (range, 1-10) 1 month after the procedure, with significant pain relief (p < .001). Pain relief was divided as 0 in 21 patients (72%), 1 in 8 patients (28%) without anyone of grade 2. There was no procedure-related complication except one patient with temporary left side weakness and sensory change which lasted 1-2 hours and subsided thereafter propably due to temporary route compression caused by previous postoperative adhesion or inadvertent intrathecal injection.
CONCLUSION
Good pain relief can be expected after CT guided ESI. CT guided ESI may have some difficulties in postoperative patient with metal devices or adhesion.