Interventional treatment of cervical radiculopathy: an observational study

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Abstract

BACKGROUND: Cervical disc herniation is one of the most common causes of pain in the upper limbs and shoulder girdle, significantly affecting patients’ quality of life, functional capacity, and sleep.

AIM: To improve treatment outcomes in patients with cervical radiculopathy through the use of epidural analgesia with glucocorticoids.

METHODS: This observational study included 110 patients diagnosed with discogenic cervical radiculopathy. Participants were divided into two groups: the study group (n=50) received interlaminar epidural injections at the cervical spine level with 2% lidocaine (2 mL) and a glucocorticoid (8 mg). The control group (n=60) underwent neurosurgical treatment for discogenic radiculopathy. Pain intensity was assessed using the Numeric Rating Scale (NRS), the Oswestry Disability Index (ODI), and the short-form McGill Pain Questionnaire at baseline and at 1, 3, and 6 months post-treatment.

RESULTS: Baseline mean scores in study group were: NRS 8.04±1.19; ODI 42.56%±2.10; McGill Pain Questionnaire 48.44±5.21. In control group: NRS 8.18±1.27; ODI 42.63%±2.62; McGill Pain Questionnaire 49.20±5.38. By the end of the 6-month follow-up, pain scores in the study group were as follows: NRS 2.64±1.17; ODI 14.28%±2.56; McGill Pain Questionnaire 24.78±3.09. By the end of the 6-month follow-up, pain scores in the control group were as follows: NRS 3.07±1.26; ODI 14.70%±2.47; McGill Pain Questionnaire 25.12±2.66. The p-values for between-group comparisons of pain intensity according to the NRS (p=0.596; p=0.308; p=0.985; p=0.063), ODI (p=0.868; p=0.125; p=0.479; p=0.386), and McGill Pain Questionnaire (p=0.480; p=0.384; p=0.052; p=0.674) at all assessment time points (pre-intervention and at 1, 3, and 6 months) exceeded the significance threshold of 0.050, indicating no statistically significant differences between the interventional and neurosurgical groups.

CONCLUSION: The results of this study indicate that interventional and surgical treatments for cervical radiculopathy yielded comparable effectiveness of the two approaches.

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About the authors

Dmitrii A. Fedorov

Federal Siberian Scientific and Clinical Center; Voyno-Yasenetsky Krasnoyarsk State Medical University

Author for correspondence.
Email: 293333666fedorov@gmail.com
ORCID iD: 0000-0002-1860-4609
SPIN-code: 6912-7740

anesthesiologist-resuscitator

Russian Federation, Krasnoyarsk; Krasnoyarsk

Vladimir V. Khinovker

Federal Siberian Scientific and Clinical Center; Voyno-Yasenetsky Krasnoyarsk State Medical University

Email: vhinov@hotmail.com
ORCID iD: 0000-0002-3162-6298
SPIN-code: 8640-9591

MD, Dr. Sci. (Medicine)

Russian Federation, Krasnoyarsk; Krasnoyarsk

Victor A. Koriachkin

Saint Petersburg State Pediatric Medical University

Email: vakoryachkin@mail.ru
ORCID iD: 0000-0002-3400-8989
SPIN-code: 6101-0578

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Ksenia O. Tutsenko

Voyno-Yasenetsky Krasnoyarsk State Medical University

Email: kseniamkib@gmail.com
ORCID iD: 0000-0003-3979-1172
SPIN-code: 5691-0828

lecturer of the department

Russian Federation, Krasnoyarsk

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Supplementary files

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2. Fig. 1. Changes in the intensity of pain syndrome on a numeric rating scale.

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3. Fig. 2. Comparative characteristics of the severity of pain according to the Oswestry Disability Index questionnaire in the interventional and neurosurgical groups at various times after treatment.

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4. Fig. 3. Comparative characteristics of pain according to the McGill questionnaire in the interventional and neurosurgical groups at various times after treatment.

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5. Fig. 4. Clustering of the studied groups based on the results of pain scales. Patients of the intervention group are marked with black squares, patients of the neurosurgical group with white diamonds.

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