Epidural lysis in the treatment of cervical pain: a retrospective follow up

Abstract

In this study the efficacy and complications of epidural lysis (corticosteroid and hypertonic saline administration) were evaluated retrospectively in 48 patients (19 males, 29 females, ages 34-63) suffering from cervical pain due to various reasons. After performing physical examination, radiodiagnostic and elecrophysiologic evaluation; conservative treatment modalities were tried. The patients who did not respond to these treatment modalities were hospitalized for epidural lysis application. The procedures were performed in the operating room, under surgical conditions with fluoroscopic guidance. 16 G R-K needle was inserted either trough the C7-T1 or T1-T2 vertebral interspace, through which a Racz catheter was placed after performing epidurography. Epidural lysis was performed for three consecutive days. The patients were followed up monthly for 6 months. The quality of pain relief (as excellent, good, moderate, poor), and opioid consumptions were evaluated. Phyisical activities, opioid consumptions and VAS values were compared before and after the procedure. Complications were recorded. VAS values were decreased significantly after the procedures. Most of the patients had significant pain relief. On complications basis 1 patient had infection on the insertion site, 1 patient had dural puncture and 2 patients had parestesis on upper extremities. We concluded that cervical epidural lysis is an effective and safe method particularly in the patients who have not had any benefit from the other conventional therapies.