CT Fluoroscopy Superior to C-Arm in Disc Herniation

CT fluoroscopy more effective and safer than C-arm fluoroscopy in cervical disc herniation

MONDAY, May 23 (HealthDay News) -- Computed tomography (CT) fluoroscopy is clinically more effective and safer than C-arm fluoroscopy for cervical transforaminal steroid injections for treatment of patients with cervical disc herniation, according to a study published in the May issue of The Spine Journal.

Jung Hwan Lee, M.D., Ph.D., and Sang-Ho Lee, M.D., Ph.D., from the Wooridul Spine Hospital in Seoul, South Korea, compared the clinical effectiveness of CT fluoroscopy and C-arm fluoroscopy for cervical transforaminal epidural steroid injection to control pain and improve function in 116 patients with cervical disc herniation. They randomly allocated 51 participants into the CT group and 65 into the C-arm fluoroscopy guidance group (C group). Changes in pain reduction and functional improvement were assessed using the Numeric Rating Scale (NRS) pain score and Neck Disability Index (NDI) values, measured before treatment and eight weeks after treatment. Reductions of 50 percent or more in NRS and a minimum of 40 percent in NDI compared with pretreatment indicated successful pain relief and functional improvement.

The investigators found that, after eight weeks, there was pain reduction and functional improvement in both groups. Reduction of NRS for arm pain and improvement of NDI was significantly better in the CT group compared to the C group. There were 10 cases of side effects in the C group but none in the CT group.

"CT fluoroscopy showed better clinical effectiveness than C-arm fluoroscopy in radiating-pain reduction and functional improvement in patients with cervical disc herniation," the authors write. "Also, CT fluoroscopy had no associated side effects and was expected to be a safer technique than C-arm fluoroscopy."

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