Page 24 - Aktinologia 01-14

Basic HTML Version

Ελληνική Ακτινολογία, Τόμος 45, Τεύχος 1, 2014
32
foramens, where spinal nerves come out.
Herniation of intervertebral disk or spondylosis, is
the main cause of the outcoming spinal root compres-
sion. This pathologic condition by mechanical and
chemical ways, leads to radicular pain.
This kind of pain especially in cervical spine is
a common cause of people visiting the physician.
First, anti-inflammatory medication and rest are rec-
ommended, but in about 20% this method fails to
give a solution. Next step in therapeutic approach
is percutaneous infiltration not only as diagnostic
procedure to determine the precise origin of cervical
pain or brachialgia, but also as a therapeutic method.
Candidates for percutaneous infiltrations must suit
some certain criteria.
Under fluoroscopy the physician makes direct or
indirect infiltrations (with corticosteroidmixture) into the
nerve root causing the pain. This procedure provides
a direct and increased concentration of medication in
inflammation site.
The method is quite accurate with great efficacy in
reducing radicular pain. It is also important to mention
that clinically significant complications are not noted
and finally it is remarkable that it is a cost- effective
procedure, a fact which is really tempting especially
nowadays.
Keywords:
cervical pain, brachialgia, epidural space,
nerve root, intervertebral disc herniation, infiltration, cor-
ticosteroid.
Radiological Department of New Ionia
“Konstantopouleio” Hospital
ΒΙΒΛΙΟΓΡΑΦΙΑ
1. Catherine Cyteval, Eric Thomas, Eric Decoux, et al. Cervical
Radiculopathy: Open study on Percutaneus Periradicular
Foraminal Steroid Infiltration Performed under CT Control
in 30 Patients. AJNR.Am J. Neuroradiol. 2004 Mar
25:441-445.
2. Horal J. The clinical appearance of low back disorders in
the city of Gothenburg, Sweden: comparisons of inca-
pacitated probands with matched controls. Acta Orthop
Scand Suppl 1969;118:1–109.
3. Jason Eubanks .Cervical Radiculopathy: Non-operative
Management of Neck pain and Radicular Symptoms.,
Ohio. 2010 Jan 1;81 (1):33-40.
4. Jean-Noel Vallee, MD,Robert Y. Carlier, MDCeline
Mutschler, MDDominique Mompoint, MD , Christian A.
Valle´e, MD . Chronic Cervical Radiculopathy: Lateral-
Approach Periradicular Corticosteroid Injection Radiology.
2001 Mar 218(3):886-892.
5. Warner Platzer. Μυοσκελετικό σύστημα.
6. Gopinathan A, Peh WCG Image-guided facet joint injec-
tion.. 1. National University Hospital, Singapore. 2 Khoo
Teck Puat Hospital, Yishun Central, Singapore.
7. Hellsing A and Bryngelsson I. Predictors of musculoskeletal
painin men. A twenty year follow-up from examination
at enlistment.Spine 2000; 25(23):3080–3086.
8. Andre G. Todd. Curr Rev .Cervical spine: degenerative
conditions . Musculoskelet Med (2011) 4:168–174.
9. Deyo RA and Weinstein JN. American Academy of
Family Physicians. Low back pain. N Engl J Med
2001;344(5):363–370.
10. Aprill C, Bogduk N. Cervical zygoapophyseal joint pain
patterns. A study in normal volunteers. Spine 1990
15:453-457.
11. Erik E. Swartz. Cervical Spine Functional Anatomy and
the Biomechanics of Injury Due to Compressive. Journal
of Athletic Training. 2005;40(3): 155-161.
12. Jeffrey S. Ross.Imaging and Interventional Procedures
of the Spine.
13. A. Kelekis, T. Somon, H. Yilmaz, P. Bize, E. Brouztzos, K.
Lovblad, D. Ruefenacht, JB. Martin.Interventional Spine
Procedures. European Journal of Radiology 55(2005)
362-383.
14. Massimo Leonardi, Christian W. Pfirrmann. Spine
Injections.
15. HainesT., Gross A., Burnie SJ.,Perry L. Patient education
for neck pain with or without radiculopathy. Cochrane
Database Syst Rev2009 Jan 21;(1):CD005106.doi:
10.1002/14651858.CD005106.pub3.
16. Eisenberg E, McNicol E, Carr DB. Opiods for neu-
ropathic pain. Cochrane Database Syst Rev 2006 Jul
19;(3):CD006146.
17. Malone DG, Baldwin NG, Tomecek J. Complication of
cervical spine manipulation therapy-5 year retrospective
study. Neurosurgery Focus.2002;13(6):ecp 1.
18. Lord SM, Barnsley L, Wallis BJ and Bogduk N. Chronic
cervical zygapophysial joint pain with whiplash: A placebo-
controlled prevalence study. Spine 1996; 21(15):1737–
1745.
19. Christian W A Pfirrmann, Patrick A Oberhozler, Marco
Zanetti et al. Selective Nerve Root Block for the treatment
of Sciatica: Evaluation of Injection Siteand Effectiveness-
A study with Patients and Cadavers. Radiology. 2001
Dec;221(3):704-711.