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Catheter-Assisted Interlaminar Approach for Cervical Epidural Steroid Injection in Patient with Cervical Stenosis Caused by Ossification of Posterior Longitudinal Ligament: A Case Report

DOI: 10.4236/crcm.2024.138036, PP. 304-308

Keywords: Catheter-Assisted Interlaminar Cervical Epidural Steroid Injection, Ossification of Posterior Longitudinal Ligament, Cervical Stenosis

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Abstract:

We present the case of a 64-year-old man with cervical ossification of the posterior longitudinal ligament (OPLL) experiencing chronic neck pain and radiculopathy for 6 months. A catheter-assisted interlaminar Cervical Epidural Steroid Injection (CESI) was performed under fluoroscopic guidance, targeting the affected C2-C6 levels. Significant improvement was observed after this procedure, with decreased pain scores (visual analogue scale (VAS) 8 to 2) and improved mobility. This technique not only enhances the effectiveness of CESI but also reduces the likelihood of complications such as stroke or epidural hematoma and thus provides an alternative treatment option for patients with multiple stenotic levels who are unsuitable for surgery or are unresponsive to conservative therapy such as medication or physical therapy.

References

[1]  Epstein, N.E. (2018) Major Risks and Complications of Cervical Epidural Steroid Injections: An Updated Review. Surgical Neurology International, 9, Article No. 86.
https://doi.org/10.4103/sni.sni_85_18
[2]  Vu, P.D., Robinson, C.L., Chen, G.H. and Hasoon, J.J. (2023) Epidural Catheters for Cervical Epidural Steroid Injections to Target Higher Cervical Pathology: Clinical Images in Practice. Cureus, 15, e48528.
https://doi.org/10.7759/cureus.48528
[3]  Kim, J.Y., Yang, S., Kim, D., Park, Y. and Kim, Y.H. (2022) Correlation between the Extent of Injectate Spread and Clinical Outcomes in Cervical Interlaminar Epidural Injection. Pain Physician, 8, E1229-E1238.
[4]  Lee, B., Lee, S.E., Kim, Y.H., Park, J.H., Lee, K.H., Kang, E., et al. (2021) Evaluation of Contrast Flow Patterns with Cervical Interlaminar Epidural Injection: Comparison of Midline and Paramedian Approaches. Medicina, 57, Article No. 8.
https://doi.org/10.3390/medicina57010008

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