Objective: The aim of this study was to prospectively evaluate the clinical efficacy of perigangliar steroid and local anesthetic with intradiscal O2-O3 injection versus steroid and local anesthetic intraforaminal injection in different types of herniation and grade of disc degeneration.
Materials And Methods: A total of 517 patients were randomly assigned to two groups. Control Group (159 men, 101 women; age range 25-89 years) underwent steroid and local anesthetic intraforaminal injection. Study Group (163 men, 94 women; age range 22-92 years) underwent the same treatment with addiction of O2-O3 intradiscal injection. Procedures were performed under computed tomographic guidance. Visual Analog Scale Questionnaire was administered before treatment and at intervals, the last at 6-month follow-up. Results were compared with Kruskal-Wallis and t test.
Results: After 6 months, O2-O3 discolysis was successful in 106 (41.24 %) Study Group patients with extrusions compared with 9 Control Group patients (3.5 %) (P < 0.001). In 89 (34.6 %) Study Group patients with protrusions, success rate was statistically significant compared with 5 Control Group patients (1.9 %). Significant difference was detected in the presence of Grade I, II, III of Degenerated Disc in 185 of Study Group patients (68.4 %) compared with 4 Control Group patients (1.5 %).
Conclusions: The addition of O2-O3 discolysis is more effective at 6 months than perigangliar steroid and local anesthetic injection, especially in cases of herniated or protruded discs and with a Grade of Disc Degeneration from mild to moderate range.
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http://dx.doi.org/10.1007/s11547-015-0598-x | DOI Listing |
PM R
March 2022
Department of Orthopaedic Surgery, Stanford University, Virginia Beach, Virginia, USA.
Background: Few studies have evaluated the effect of final needle position on contrast flow patterns during the performance of cervical transforaminal epidural steroid injections (TFESIs).
Objective: To analyze fluoroscopically guided cervical TFESI contrast flow patterns based upon final needle tip position.
Design: Retrospective, observational in vivo study.
Pain Med
October 2020
PM&R Section, Department of Orthopaedic Surgery and Neurosurgery, Stanford University, Redwood City, California, USA.
Objective: A modification of the conventional technique for cervical transforaminal epidural steroid injection (CTFESI) has been developed. This technique may, theoretically, decrease the likelihood of the needle encountering the vertebral artery and spinal nerve. The approach uses angle measurements of the superior articular process ventral surface from the patient's axial MRI as a guide for fluoroscopic set-up and needle trajectory.
View Article and Find Full Text PDFPain
September 2019
Department of Cell and Developmental Biology, Silberman Institute of Life Sciences and the.
Neuropathic pain is frequently driven by ectopic impulse discharge (ectopia) generated in injured peripheral afferent neurons. Observations in the spinal nerve ligation (SNL) model in rats suggest that cell bodies in the dorsal root ganglion (DRG) contribute 3 times more to the ectopic barrage than the site of nerve injury (neuroma). The DRG is therefore a prime interventional target for pain control.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
May 2017
From the Division of Interventional Neuroradiology (L.G., D.E.S., P.G.)
Background And Purpose: Flat panel catheter angiotomography performed during the selective injection of intersegmental arteries offers a multiplanar assessment of the intraforaminal course of the radicular arteries providing an anterior radiculomedullary artery. Injury of anterior radiculomedullary arteries during transforaminal epidural steroid injections can result in spinal cord damage. Evaluations of the intraforaminal location of these arteries have so far been limited to anteroposterior views or the examination of cadaveric material.
View Article and Find Full Text PDFReg Anesth Pain Med
March 2017
From the *Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht; †Philips Healthcare, Best; Departments of ‡Radiology and §Clinical Epidemiology & Medical Technology Assessment, Maastricht University Medical Center; and ‖Department of Anatomy and Embryology, Maastricht University, Maastricht; and ¶Department of Anesthesiology, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
Spectral tissue sensing (STS) exploits the scattering and absorption of light by tissue. The main objective of the present study was to determine whether STS can discriminate between correct and incorrect placement of the needle tip during lumbar transforaminal epidural injection. This was a single-blind prospective observational study in 30 patients with lumbar radicular pain scheduled for lumbar transforaminal epidural injection.
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