Delphine Richarme MD, Presenter: Nothing to Disclose

Antoine A. Feydy MD, Abstract Co-Author: Nothing to Disclose

Fouad Fayad MD, Abstract Co-Author: Nothing to Disclose

Fabrice Stephane Thevenin MD, Abstract Co-Author: Nothing to Disclose

Raphael Campagna MD, Abstract Co-Author: Nothing to Disclose

Jean-Luc Drape MD, PhD, Abstract Co-Author: Nothing to Disclose

Henri Guerini MD, Abstract Co-Author: Nothing to Disclose

Alain Chevrot MD, Abstract Co-Author: Nothing to Disclose

Claire Jourdan MD, Abstract Co-Author: Nothing to Disclose

Katerina Sanchez, Abstract Co-Author: Nothing to Disclose

Abdelkader Hajjioui, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Cervical foraminal injection performed with a direct approach of the foramen may induce serious neurologic complications. Cervical facet joint (CFJ) injections are easier to perform and safe, and may diffuse in the epidural and foraminal spaces. We analyzed the efficiency and tolerance of CT-guided CFJ slow-acting corticosteroid injection in patients with radiculopathy related to discal herniation.

Pilot study included 17 patients presenting typical cervical radiculopathy related to discal herniation without relief of pain after medical treatment (one month duration). CFJ puncture was performed under CT guidance with a lateral approach, then an injection of non neurotoxic iodinated contrast agent (1 ml) was performed with CT control of CFJ opacification, followed by an injection of slow-acting corticosteroid (25 mg). Main criteria for judgment was pain relief one month later (delta visual analogic scale AVS for 0 to 100mm). Diffusion of iodinated contrast agent in the foramen was assessed by two radiologists in consensus.  

Pain relief was significant at one month (delta VAS 22 ± 23 mm, p=0,001) and 41% (7/17) of patients had pain relief more than 50%. In cases with foraminal diffusion, pain relief more than 50% occured in 5 patients (50%) and only in 2 patients (29%) in cases without foraminal diffusion. No complication occured.  

CT-guided CFJ slow-acting corticosteroid injection is safe and provided good results at one month follow-up.

CT- guided CFJ injection may be considered as an interesting alternative treatment for patients suffering from cervical radicular pain related to discal herniation and resistant to medical treatment.

Richarme, D, Feydy, A, Fayad, F, Thevenin, F, Campagna, R, Drape, J, Guerini, H, Chevrot, A, Jourdan, C, Sanchez, K, Hajjioui, A, et al, , Cervical Radiculopathy: Efficiency of CT- guided Cervical Facet Joint Corticosteroid Injection.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6021142.html