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Wirelessly Powered, Battery-Free Peripheral Neurostimulation for the Treatment of Craniofacial Pain: Interim Results of a Prospective Randomized Controlled Trial

Year: 2022

Type: article

Abstract: of background data: Most patients who receive surgical treatment are evaluated by the physician who performs the operation.However, many patients who receive cervical epidural steroid injections (ESIs) have injections ordered by physicians who do not perform the procedure.Objectives: To compare success rates of fluoroscopically-guided cervical ESIs in patients evaluated and referred for an injection by a fellowship-trained spine interventionalist (Group-I), versus patients evaluated by and referred for an injection by spine surgeons at the same institution (Group-S).Methods: Current procedural terminology (CPT) codes were used to retrospectively search all consecutive patients who received a cervical ESI between January 2010 and October 2018.All patients with pre-and post-injection Numerical Rating Scale (NRS) pain scores within 60 days of the injection were included in the analysis.Injection success was defined as at least 50% improvement in NRS.Results: All 363 ESIs, 178 Transforaminal (TF) and 185 Interlaminar (IL), were performed by the same fellowship-trained spine interventionalists with 275 patients in Group-I and 88 in Group-S.Overall, 52% [95% CI 47 -57%] achieved a successful outcome with significantly higher success in Group-I 57% [95% CI 51 -63%] compared to a Group-S 38% [95% CI 28 -48%].Based on injection type, there was a trend towards higher success rates for TF in Group-I (50% [41 -59%]) compared to Group-S (38% [26 -50%]), and for IL in Group-I (62% [55 -69%]) compared to Group-S (38% [14 -62%]).In addition, Group-I had a significantly higher proportion of patients achieving at least 80% pain relief (31% [95% CI 26 -36%]) compared to Group-S (17% [95% CI 9 -25%]).Discussion/Conclusion: Patients referred for a cervical ESI by a physician in the specialty that performs the injection achieved greater pain reduction than those referred by physicians who do not perform the procedure.

Source: Interventional Pain Medicine

DOI: 10.1016/j.inpm.2022.100022