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Neck Pain? Watch it Dye on Fluoroscopy
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Posted on: 11/30/1999
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This is the first study to look at the number and type of problems after neck injections using a fluoroscope. In fluoroscopy, a video X-ray image guides the doctor in placing the needle. By injecting a dye into the covering that surrounds the spinal cord, the doctor is able to guide the needle into the exact spot and not the nearby tissue or blood vessels.
All patients had neck pain that goes down the arm. This condition is called cervical radiculopathy. For these patients, the cause of their symptoms was either a herniated disc or cervical spondylosis. Cervical spondylosis is a general term for joint damage in the neck that occurs over time from osteoarthritis. The nearby ligaments, soft tissues, and discs are also affected.
Each patient had one or more steroid injections. Most patients had two injections. Problems occurred in just under 17 percent of the patients per injection. Increased neck pain at the injection site was the most common symptom after injection. Other symptoms included headache, difficulty sleeping, and facial flushing. Rarely, meningitis, breathing problems, or arm weakness occurred.
According to this study, none of the complications was linked to patient age or the number of injections. Whether a lawsuit is pending doesn't seem to affect the outcome either. No one had more than one complication per injection. All problems went away without the need for a hospital visit or further treatment.
The authors conclude that fluoroscopically guided injections to the epidural space of the cervical spine are safe and effective. Used for patients with cervical radicular pain, these injections have a low number of problems that generally go away without treatment.
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References:
Kenneth P. Botwin, MD, et al. Complications of Fluoroscopically Guided Interlaminar Cervical Epidural Injections. In Archives of Physical Medicine and Rehabilitation. May 2003. Vol. 84. No. 5. Pp. 627-633.
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