Treatment of Chronic Thoracic and Neck and Upper Extremity Pain
Summary
To study improvements or lack thereof with the interlaminar epidural patients with or without steroids experiences mid back, upper back or neck pain with or without chest wall and upper extremity pain of at least 6-months duration non-responsive to conservative management.
Description
This is a Single-center, prospective, controlled, double-blind, randomized study in thoracic and cervical regions.
Patients are studied in 2 groups in each region.
- Group I-local anesthetic only.
- Group II-local anesthetic with 6 mg of non-particulate Celestone.
All patients will be unblinded at 12 or 24 months. Non-responsive patients will be unblinded after 3 months and will be crossed over to a different group, if patient consents. Non-responsive patients may be unblinded and withdrawn from the study at any time.
Study Design
Allocation: Randomized, Control: Dose Comparison, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
Conditions
Back Pain
Intervention
Thoracic and cervical interlaminar epidural injections, Xylocaine, Celestone
Location
Ambulatory Surgery Center
Paducah
Kentucky
United States
42001
Status
Active, not recruiting
Source
Pain Management Center of Paducah
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT01071369
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Cervical Rib Syndrome
A condition associated with compression of the BRACHIAL PLEXUS; SUBCLAVIAN ARTERY; and SUBCLAVIAN VEIN at the thoracic outlet and caused by a complete or incomplete anomalous CERVICAL RIB or fascial band connecting the tip of a cervical rib with the first thoracic rib. Clinical manifestations may include pain in the neck and shoulder which radiates into the upper extremity, PARESIS or PARALYSIS of brachial plexus innervated muscles; sensory loss; PARESTHESIAS; ISCHEMIA; and EDEMA. (Adams et al., Principles of Neurology, 6th ed, p214)
Cervical Plexus
A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm.
Injections, Epidural
The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.
Cervical Rib
A supernumerary rib developing from an abnormal enlargement of the costal element of the C7 vertebra. This anomaly is found in 1-2% of the population and can put pressure on adjacent structures causing CERVICAL RIB SYNDROME; THORACIC OUTLET SYNDROME; or other conditions.
Blood Patch, Epidural
The injection of autologous blood into the epidural space either as a prophylactic treatment immediately following an epidural puncture or for treatment of headache as a result of an epidural puncture.
Clinical Trials
Treatment of Chronic Low Back and Lower Extremity Pain
1. To demonstrate clinically significant improvements in patients undergoing lumbar interlaminar epidurals. Improvement will be assessed in relation to the clinical outcome measu...
The purpose of this study is to compare whether epidural analgesia would provide equal analgesia than combining intrathecal opioids with thoracic paravertebral local anesthetics.
Under the influence of epidural analgesia, patients may not feel the urge to urinate, which can result in urinary retention and bladder overdistension. The use of a transurethral catheter...
Conservative Therapy Versus Epidural Steroids for Cervical Radiculopathy
The main objective of this study is to determine whether interventional treatment (i.e. epidural steroids), conservative therapy, or the combination, is superior for cervical radiculopathy...
Safety Study of Different Needle Types During Epidural Injections.
Interventional spine procedures are becoming more common. Safety is partly related to proper technique. Injection of steroids and local anesthetics in the vascular space may have serious...
PubMed Articles
Technique for CT Fluoroscopy-Guided Cervical Interlaminar Steroid Injections.
OBJECTIVE: We describe the use of CT fluoroscopy as a guidance tool for performing interlaminar epidural steroid injections in the cervical spine. CONCLUSION: CT fluoroscopy is an alternative method t...
Abstract Background. Lumbar spinal stenosis is a common condition that causes axial low back pain, radicular pain, and neurogenic claudication. Epidural steroid injections are commonly used for the tr...
Epidural steroid injection (ESI) is the most commonly performed intervention in pain clinics across the United States. This article provides an evidence-based review of ESI, including data on efficacy...
Abstract Objective. To assess the efficacy of fluoroscopically guided, contrast-enhanced lumbar interlaminar epidural steroid injections (IL-ESI) for lower limb pain greater than axial low back pain u...
Prevalence of anatomic impediments to interlaminar lumbar epidural steroid injection.
Hameed F, Hunter DJ, Rainville J, Li L, Suri P. Prevalence of anatomic impediments to interlaminar lumbar epidural steroid injection.
