Abstract

Objective: To assess the outcome of minimally invasive CT guided perineural root injection in treatment of radiculopathy Design: Retrospective chart review. Materials: 1312 procedures of CT guided trans-foraminal perineural root injections were enrolled between 2003-2009. Injection of 1mL of 40 mg of Triamcinolone Acetonide and 1 mL of 0.5% of Bupivacaine was given. Selection criteria for the 1st injection were pain persisting longer than 1 month, no objective neurological deficit, and radiological evidence of root compression of benign nature. Selection criterion for repeated injections was acute exacerbation of the previously known radicular pain. Outcome measures: Primary outcome measure was pain relief using visual analogue score at 6 weeks post injection. Results: 1312 procedures were performed in 446 patients. 227 patients (51%) with cervical radiculopathy and 219 patients (49%) with lumbosacral radiculopathy. 85% had 3 injections, 6% had 2 injections, 3.3% had 1 injection and 4.7% had more than 3 injections. 72 patients (16%) had pervious spinal surgery. There was no root injury, 8 patients had wrong level injected and the procedure was repeated in later date and 10 patients had the procedure abandoned due to increased pain. 250 patients (56%) reported pain reduction of at least 50% in 1st injection. 331 patients (74%) reported pain reduction of at least 50% in subsequent injections during the acute exacerbation of the previously known radicular pain. Conclusion: Minimally invasive CT guided trans-foraminal perineural root injection in treatment of radiculopathy could be helpful, epically if given in acute exacerbation of pain, and should be included to the armamentarium of conservative management of radiculopathy