PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Research Article

Volume 1 Issue 6

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


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.


  1. Abdi S., et al. “Epidural steroids in the management of chronic spinal pain: A systematic review”. Pain Physician 10 (2007): 185-212.
  2. Sitzman BT. Epidural Injections. In: Fenton D, editor. Image-Guided Spine Intervention. Philadelphia: WB Saunders (2003): 100-1.
  3. Benoist M, Boulu P and Hayem G. “Epidural steroid injections in the management of low-back pain with radiculopathy: An update of their efficacy and safety”. Eur Spine J 21 (2012): 204-13.
  4. Tauheed N, Usmani H and Siddiqui AH. “A comparison of the analgesic efficacy of transforaminal methylprednisolone alone and with low doses of clonidine in lumbo-sacral radiculopathy”. Saudi J Anaesth 8 (2014): 51-8.
  5. El-Yahchouchi C., et al. “The noninferiority of the nonparticulate steroid dexamethasone vs. the particulate steroids betamethasone and triamcinolone in lumbar transforaminal epidural steroid injections”. Pain Med 14 (2013): 1650-7.
  6. Bogduk N. “Practice Guidelines for Spinal Diagnostic Procedures”. San Francisco, CA: International Spine Intervention Society (2004).
  7. Rathmell JP, Aprill C and Bogduk N. “Cervical transforaminal injection of steroids”. Anesthesiology 100 (2004): 1595-600.
  8. Scanlon GC., et al. “Cervical transforaminal epidural steroid injections: More dangerous than we think?”. Spine 32 (2007): 1249-56.
  9. Tiso RL., et al. “Adverse centralnervous system sequelae after selective transforaminal block: The role of corticosteroids”. Spine J 4 (2004): 468-74.
  10. Derby R., et al. “Size and aggregation of corticosteroids used for epidural injections”. Pain Med 9 (2008): 227-34.
  11. Dreyfuss P, Baker R and Bogduk N. “Comparative effectiveness of cervical transforaminal injections with particulate and nonparticulate corticosteroid preparations for cervical radicular pain”. Pain Med 7.3 (2006): 237-42.
  12. Shakir A, Ma V and Mehta B. “Comparison of pain score reduction using triamcinolone vs. dexamethasone in cervical transforaminal epidural steroid injections”. Am J Phys Med Rehabil 92 (2013): 768-775.
  13. MacMahon PJ, Eustace SJ and Kavanagh EC. “Injectable corticosteroid and local anesthetic preparations: A review for radiologists”. Radiology 3 (2009): 647-61.
  14. Sitzman BT. “Pharmacologic properties of common glucocorticoids used in spine injections”. in Fenton DS, Czervionke LF (eds): Image-Guided Spine Intervention. Philadelphia, PA, Elsevier (2003): 291.
  15. Lee JW., et al. “Cervical transforaminal epidural steroid injection for the management of cervical radiculopathy: A comparative study of particulate versus non-particulate steroids”. Skeletal Radiol 38 (2009): 1077-82.
  16. Radhakrishnan K., et al. “Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990”. Brain 117.2 (1994): 325-35.
  17. Sampath P., et al. “Outcome in patients with cervical radiculopathy. Prospective, multicenter study with independent clinical review”. Spine (Phila Pa 1976) 24.6 (1999): 591-7.
  18. Cicala RS, Thoni K and Angel JJ. “Long-term results of cervical epidural steroid injections”. Clin J Pain 5 (1989): 143-5.
  19. Slipman CW., et al. “Therapeutic selective nerve root block in the nonsurgical treatment of atraumatic cervical spondylotic radicular pain: A retrospective analysis with independent clinical review”. Arch Phys Med Rehabil 81 (2000): 741-6.
  20. Bush K and Hillier S. “Outcome of cervical radiculopathy treated with periradicular/epidural corticosteroid injections: A prospective study with independent clinical review”. Eur Spine J 5 (1996): 319-25.