Retrospective Observational Study of Cervical Epidural Injection: A Comparison Between Dexamethasone vs Triamcinolone
Yogita M Bhargude*, Manjiri Ranade, Rutvi Mody, Prakash Deshmukh and Kailash Kothari
May 29, 2023
Abstract
Introduction: Cervical epidural steroid injections (CESI) have been frequently used since long time for diagnosis and treatment cervical radiculopathies. cervical epidural corticosteroid injection helps in reducing swelling and inflammation of the compressed nerves, hence improving pain for several days to months or longer which leads to help delaying or avoiding the need for surgery.
In this retrospective observational study, we aim to compare clinical efficacy of Dexamethasone vs Triamcinolone in the management of chronic neck, shoulder and arm pain due to herniated intervertebral disc in the cervical region.
Methodology: a retrospective observational study of 1 year follow up was performed in 100 patients of either sex complaining of chronic neck pain with signs of cervical radiculopathy. Patients were divided into 2 groups of 50 each. Those in Group A received Injection Dexamethasone sodium phosphate 12mg and in Group B received Injection Triamcinolone acetonide 40mg in the cervical epidural space under fluoroscopy guidance. All the patients were monitored before the procedure and post-procedure for 4 h following epidural injection and subsequently followed by at the 10 days, 1 month, 3 months, 6 months, 8 months, 10 months and 1 year on telephonic conversation. The primary outcome was to measure the intensity of pain using Visual Analog score (VAS) score of 0-10.
Result: The mean VAS score in both the group A and B pre-procedure was 8.6 and 8.78 respectively and Mean VAS scores were significantly improved to 2.16 and 1.90 respectively post-procedure during 1 year follow up with p value of 0.76. hence from mentioned quantitative data it can be stated that there is no statistically significant difference in the efficacy of both the drugs used in cervical epidural injection.
Conclusion: Based on the results, this retrospective study strengthens the existing evidence that dexamethasone can produce equivalent pain relief to triamcinolone for the treatment of cervical radiculopathy. Though the need for more research studies to prove that Dexamethasone can be used an effective alternative to Triamcinolone continues.
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