Clinical Efficacy of Epidural Injections of Local Anesthetic Alone or Combined with Steroid for Neck Pain: A Systematic Review and Meta-Analysis
Table 4
Characteristics of included studies on cervical epidural injections in neck pain.
Study/study type Methodologic quality scoring
Participants and interventions
Outcome measure
Follow-up period
Conclusions
Manchikanti et al. (36)/RCT Quality scores: ;
Epidural injections without steroid, Epidural injections with steroid, Group I: cervical interlaminar epidural injections with 5 ml of 0.5% lidocaine Group II: cervical interlaminar epidural injections with 4 ml of 0.5% lidocaine mixed with 1 mL or 6 mg of nonparticulate betamethasone
NDI, NRS, opioid intake, work status
1 year
Cervical interlaminar epidural injections had an efficacy of 71.5% for pain reduction and improvement in functional status for neck pain.
Manchikanti et al. (37)/RCT Quality scores: ;
Epidural injections without steroid, Epidural injections with steroid, Group I: cervical interlaminar epidural injections with 5 ml of 0.5% lidocaine Group II: cervical interlaminar epidural injections with 4 ml of 0.5% lidocaine mixed with 1 ml or 6 mg of nonparticulate betamethasone
NDI, NRS, opioid intake, work status
2 years
Cervical interlaminar epidural injections for chronic neck pain was effective in 72% of patients in group I and 68% of patients in group 2.
Manchikanti et al. (38)/RCT Quality scores:
Epidural injections without steroid, Epidural injections with steroid, Group I: cervical interlaminar epidural injections with 5 mL of 0.5% lidocaine Group II: cervical interlaminar epidural injections with 4 ml of 0.5% lidocaine mixed with 1 ml or 6 mg of nonparticulate betamethasone
NDI, NRS, opioid intake, work status
2 years
Cervical epidural injections of local anesthetic with or without steroids were effective in 71% of patients.
Manchikanti et al. (39)/RCT Quality scores:
Epidural injections without steroid, Epidural injections with steroid, Group I: cervical interlaminar epidural injections with 5 ml of 0.5% lidocaine Group II: cervical interlaminar epidural injections with 4 ml of 0.5% lidocaine mixed with 6 mg of nonparticulate betamethasone
NDI, NRS, work status
2 years
Cervical interlaminar epidural injections for chronic neck pain alleviated pain relief and improved functional status by ≥50% in 69% of patients in group I and 71% of patients in group 2 at the 2-year follow-up.
IPM-QRB: Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment; NDI: Neck Disability Index; NRS: numeric rating scale; RCT: randomized controlled trial.
