Cervical Epidural Injection, Chronic Neck Pain, Radicular Pain
Conditions
Keywords
Cervical Epidural Steroid Injection, Needle Depth Estimation, Ultrasound Guidance, MRI Guidance, Fluoroscopy, Radiation Exposure, Chronic Pain Management
Brief summary
This study aims to evaluate the reliability of magnetic resonance imaging (MRI) and ultrasound (USG) in predicting needle depth during cervical epidural injections, compared to fluoroscopy. The goal is to identify alternative imaging methods that reduce radiation exposure while maintaining procedural accuracy and patient safety.
Detailed description
Cervical epidural steroid injections (CESI) are commonly used to manage chronic neck and radicular pain. Accurate needle placement is critical for the success and safety of the procedure. Fluoroscopy is the standard method for guiding the needle; however, it exposes patients and clinicians to ionizing radiation. This study compares pre-procedural MRI and USG measurements of needle depth with fluoroscopy-guided needle depth during CESI. Primary Objective: Assess the agreement between MRI, USG, and fluoroscopy measurements of needle depth using intraclass correlation coefficients (ICC) within a ±0.3 cm tolerance. Secondary Objectives: Evaluate the correlation between fluoroscopic lateral imaging frequency and radiation exposure. The study is a methodological observational study conducted at Ankara Etlik City Hospital, involving adult patients undergoing CESI. Data will be collected retrospectively and prospectively for eligible participants.
Interventions
PROCEDURENeedle Depth Measurement Using MRI, Ultrasound, and Fluoroscopy
This intervention involves cervical epidural steroid injection (CESI) for patients with chronic neck and radicular pain. Needle depth is measured pre-procedurally using MRI and ultrasound to predict the ideal needle placement. Fluoroscopy is used during the procedure to confirm and compare these measurements, aiming to evaluate the accuracy of imaging techniques and minimize radiation exposure.
Sponsors
Ankara Etlik City Hospital
Damla Yürük
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Age ≥ 18 years, Diagnosed with chronic cervical pain, Referred for cervical epidural steroid injection, Patients capable of providing informed consent.
Exclusion criteria
Age \< 18 years, Pregnancy or breastfeeding, History of coagulation disorders or use of anticoagulants, Severe systemic infections or local infections at the injection site, Known allergy to steroids or local anesthetics, Uncontrolled diabetes mellitus, Patients with spinal tumors or significant spinal deformities, Previous cervical spine surgery, Cognitive impairment preventing informed consent or follow-up participation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Accuracy of Needle Depth Prediction Using MRI and Ultrasound Compared to Fluoroscopy in Cervical Epidural Steroid Injections | 1 day (during the procedure) | The primary outcome measure evaluates the reliability and accuracy of pre-procedural needle depth measurements obtained using MRI and ultrasound imaging compared to intra-procedural fluoroscopy during cervical epidural steroid injections. The goal is to determine the concordance between these imaging techniques and assess their utility in reducing procedural radiation exposure. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Radiation Exposure During Cervical Epidural Steroid Injections | 1 day (during the procedure) | The secondary outcome measure assesses the level of radiation exposure (in mGy) experienced by patients and practitioners during cervical epidural steroid injections when fluoroscopy is used. Comparisons will be made to determine if the use of pre-procedural MRI or ultrasound reduces fluoroscopy duration and radiation exposure. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactDAMLA YÜRÜK, Associate Professor of Algolog
Backup ContactTAYLAN AKKAYA, Professor of Algolog
Outcome results
None listed