Clinical Course of Cervical Percutaneous Epidural Neuroplasty in Single-Level Cervical Disc Disease with 12-Month Follow-up

• Published in: Pain physician 2017-09, Vol.20 (6), p.E941-E949
• Main Authors: Oh, Chang Hyun, Ji, Gyu Yeul, Shin, Dong Ah, Cho, Pyung Goo, Yoon, Seung Hwan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arm - physiopathology; Cervical Vertebrae - surgery; Epidural; Epidural Space; Female; Follow-Up Studies; Humans; Intervertebral Disc Degeneration - complications; Intervertebral Disc Degeneration - surgery; Intervertebral Disc Displacement - complications; Intervertebral Disc Displacement - surgery; Male; Middle Aged; Neck pain; Neck Pain - etiology; Neck Pain - surgery; Neuralgia - etiology; Neuralgia - surgery; Neurosurgical Procedures - adverse effects; Neurosurgical Procedures - methods; Orthopedic Procedures - adverse effects; Orthopedic Procedures - methods; Outcome Assessment (Health Care); Retrospective Studies
• ISSN: 1533-3159; 2150-1149

Cervical disc disease is a common and occasionally disabling condition, occurring as a natural consequence of aging in the vast majority of the adult population. Percutaneous epidural neuroplasty (PEN) has been used to deliver highly concentrated drugs for chronic neck pain and to prevent scarring in cases refractory to conventional epidural blocks. However, the clinical course after PEN in cervical disc disease is not well-documented. The purpose of this study was to evaluate the efficacy of cervical PEN for single-level cervical disc disease. A retrospective observational study. A consecutive series of 100 patients who underwent cervical PEN for single-level disc disease (bulging or protrusion) were included in this study. Preoperatively, all patients underwent magnetic resonance imaging (MRI), and visual analog scale (VAS) scores as well as Odom's criteria were measured preoperatively and at post-operative follow-up visits (one, 3, 6, and 12 months). The results of this study are limited by the lack of a control group that did not undergo treatment with PEN. Additional block therapy was performed in 58 patients (58.0%). Subsequent surgery was performed in 10 patients (10.0%, excluded from data of clinical follow-up). Mean neck pain and VAS arm pain scores for all follow-up patients decreased from 6.82 and 4.74 preoperatively to 2.18 and 1.87 at 12 months after PEN (P < 0.001). More than 80% and 40% of all patients with and without additional block therapy after cervical PEN, respectively, showed good and excellent outcomes according to Odom's Criteria during 12 months of follow-up. During this follow-up period, no severe complications related to the procedure were observed. Cervical PEN was shown to be a safe and effective treatment for neck and arm pain in single-level disc disease during 12 months of follow-up. Key words: Neck pain, cervical disc disease, pain management, percutaneous epidural neuroplasty, adhesiolysis, clinical course.