Efficacy of CT Guided Perineural and Facet Joint Steroid Injection in Patients with Chronic Spinal Pain

Abstract

Introduction: Image guided interventions are increasingly being used for the management of chronic low back ache. It has inherent advantages of confirming needle placement and thus increasing precision of these procedures. Aim: To assess the efficacy of pain relief provided by CT guided perineural and CT guided facet joint steroid injections respectively in patients with chronic spinal pain. Materials and Methods: A prospective study was performed to analyse the effect of image guided procedures in providing adequate pain relief. Patients were asked to grade pain on a Visual Analog Scale (VAS) for pain before the procedure as well as on subsequent reviews at 3 days, 30 days and 90 days. The pain score was used to calculate percentage of pain relief since previous follow-up and classified accordingly. Results: A total of 67 perineural injections and 20 facetal injections were administered. In present study, out of 67 perineural injections at least 31.5% reported very good pain relief as early as 3 days post-injection, while 28.3% continued to have very good pain relief at the end of 30 days but this fell to 10.4% at the end of 90 days. Out of 20 facet joint injections, none of the patients reported good pain relief during the follow-up. Conclusion: CT-guided perineural steroid injections for management of chronic low back ache are safe and effective interventions that can be incorporated into any existing interventional radiology practice.

Keywords

• image guided interventions
• lumbo-sacral spine
• sciatica