Transforaminal versus intra-articular facet steroid injections for the treatment of cervical radiculopathy : a randomized, double-blinded, controlled study
dc.contributor.advisor | De Guise, Jacques | |
dc.contributor.advisor | Hagemeister, Nicola | |
dc.contributor.author | Bureau, Nathalie | |
dc.date.accessioned | 2014-10-20T19:53:10Z | |
dc.date.available | NO_RESTRICTION | fr |
dc.date.available | 2014-10-20T19:53:10Z | |
dc.date.issued | 2014-09-22 | |
dc.date.submitted | 2014-04 | |
dc.identifier.uri | http://hdl.handle.net/1866/11252 | |
dc.subject | Cervico-brachialgie | fr |
dc.subject | Rachis cervical | fr |
dc.subject | Hernie discale | fr |
dc.subject | Intervention spinale | fr |
dc.subject | Infiltrations facettaires | fr |
dc.subject | Infiltrations foraminales | fr |
dc.subject | Traitement de la douleur | fr |
dc.subject | Cervical spine | fr |
dc.subject | Cervical radiculopathy | fr |
dc.subject | Cervical disc herniation | fr |
dc.subject | Cervical spondylosis | fr |
dc.subject | Cervical foraminal stenosis | fr |
dc.subject | Spine injections | fr |
dc.subject | Transforaminal steroid injections | fr |
dc.subject | Intra-articular facet steroid injections | fr |
dc.subject | Spine intervention | fr |
dc.subject | Pain management | fr |
dc.subject.other | Health Sciences - Radiology / Sciences de la santé - Radiologie (UMI : 0574) | fr |
dc.title | Transforaminal versus intra-articular facet steroid injections for the treatment of cervical radiculopathy : a randomized, double-blinded, controlled study | |
dc.type | Thèse ou mémoire / Thesis or Dissertation | |
etd.degree.discipline | Sciences biomédicales | fr |
etd.degree.grantor | Université de Montréal | fr |
etd.degree.level | Maîtrise / Master's | fr |
etd.degree.name | M. Sc. | fr |
dcterms.abstract | Les infiltrations foraminales cervicales sont associées à un risque de complications neurologiques majeures. Cette étude compare l’efficacité des infiltrations facettaires, plus sécuritaires, à celle des infiltrations foraminales dans le traitement de la cervico-brachialgie secondaire à une spondylose et/ou à une hernie discale, à 4 semaines post traitement. Cinquante-six sujets ont été randomisés pour recevoir une infiltration foraminale (15 hommes, 13 femmes ; âge moyen 52 ans) ou facettaire (8 hommes, 20 femmes ; âge moyen 44 ans). L’issue principale était l’intensité de la douleur mesurée sur une échelle visuelle analogique (0 – 100). Les issues secondaires étaient le Neck Disability Index et le Medication Quantitative Scale. Suivant les analyses en intention-de-traiter et en intention-du-protocole, pour un score de douleur initial moyen, une réduction significative de l’intensité de la douleur a été observée avec les infiltrations facettaires [45.3% (95%CI: 21.4; 69.2) et 37.0% (95%CI: 9.2; 64.7)] contrairement aux infiltrations foraminales [9.8% (95%CI: +11.5; 31.2) et 17.8% (95%CI: +6.6; 42.2)]. Les infiltrations facettaires ont procuré une amélioration cliniquement (mais non statistiquement) significative du Neck Disability Index [24.3% (95%CI: +2.9; 51.5) et 20.7% (95%CI: +6.2; 47.6),], contrairement aux infiltrations foraminales [9.6% (95%CI: +15.2; 34.4) et 12.8% (95%CI: +11.2; 36.7)]. Les infiltrations facettaires étaient au moins aussi efficaces que les infiltrations foraminales pour un score initial de douleur ≤ 60, alors que l’analyse de non infériorité n’était pas concluante pour un score initial ≥ 80, de même que pour le Neck Disability Index. Les infiltrations n’ont pas été associées à une réduction du score de Medication Quantitative Scale. Les infiltrations facettaires sont efficaces dans le traitement de la névralgie cervico-brachiale et représentent une alternative valable et plus sécuritaire aux infiltrations foraminales. | fr |
dcterms.abstract | Transforaminal corticosteroid injections can be performed in the management of cervical radiculopathy but carry the risk of catastrophic complications. This study compares the efficacy of transforaminal and facet corticosteroid injections at 4 weeks post treatment. We randomly assigned 56 subjects to receive CT-guided transforaminal (15 men, 13 women; mean age 52 years; range 28 – 72 years) or facet (8 men, 20 women; mean 44 years; range 26 – 60 years) injections. The primary outcome was pain severity rated on a visual analog scale (0-100). Secondary outcome measures were the Neck Disability Index and the Medication Quantitative Scale. In the intention-to-treat and as-treated analyses, for a mean baseline score, facet injections demonstrated a significant pain score reduction of 45.3% (95%CI: 21.4; 69.2) and 37.0% (95%CI: 9.2; 64.7), while transforaminal injections showed nonsignificant pain score reduction of 9.8% (95%CI: +11.5; 31.2) and 17.8% (95%CI: +6.6; 42.2). While facet injections demonstrated an improvement in Neck Disability Index score of [24.3% (95%CI: +2.9; 51.5); 20.7% (95%CI: +6.2; 47.6),] as opposed to transforaminal injections [9.6% (95%CI: +15.2; 34.4); 12.8% (95%CI: +11.2; 36.7)], the results did not reach statistical significance. Noninferiority of facet to transforaminal injections was demonstrated for baseline pain score ≤ 60, while noninferiority analysis was inconclusive for baseline pain score ≥ 80 and for the Neck Disability Index score. Neither intervention showed a significant medication intake score reduction over time. Facet injections are effective for the treatment of cervical radiculopathy and represent a valid and safer alternative to transforaminal injections. | fr |
dcterms.description | Cette étude a été subventionnée par le Fonds de recherche du Québec - Santé (FRQ-S, grant # 21230 – 2) | fr |
dcterms.language | eng | fr |
Files in this item
This item appears in the following Collection(s)
This document disseminated on Papyrus is the exclusive property of the copyright holders and is protected by the Copyright Act (R.S.C. 1985, c. C-42). It may be used for fair dealing and non-commercial purposes, for private study or research, criticism and review as provided by law. For any other use, written authorization from the copyright holders is required.