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.(Korean J Pain 2007; 20: 46-49)