Rofo
DOI: 10.1055/a-1161-9358
Musculoskeletal System

CT-guided Interventional Therapy of Back Pain – Predictors of Success in Treatment

Article in several languages: English | deutsch
Christoph Alexander Stueckle
1  University Witten/Herdecke, Faculty of Health, Witten, Germany
2  Diagnostic and Interventional Radiology, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Germany
4  Medical Center MVZ Professor Uhlenbrock & Partner GmbH, Dortmund, Germany
,
Sarah Talarczyk
1  University Witten/Herdecke, Faculty of Health, Witten, Germany
4  Medical Center MVZ Professor Uhlenbrock & Partner GmbH, Dortmund, Germany
,
Benedikt Hackert
3  Department of Psychology/ Psychotherapy, University Witten/Herdecke, Germany
,
Martin Wawro
4  Medical Center MVZ Professor Uhlenbrock & Partner GmbH, Dortmund, Germany
,
Patrick Haage
2  Diagnostic and Interventional Radiology, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Germany
,
Ulrich Weger
3  Department of Psychology/ Psychotherapy, University Witten/Herdecke, Germany
› Author Affiliations

Abstract

Purpose The aim of the presented study was to investigate if distribution of the drug-contrast medium mixture in CT-guided periradicular therapy can predict intervention success.

Materials and Methods Over a 15-month period, 97 patients admitted to our institution by a pain physician for CT guided periradicular therapy were treated. In 420 CT guided interventions, we measured the relative distribution of the drug mixture in relationship to the neuroforamen. The distribution was correlated to the patient’s pain score over time. In addition, dependence of success in treatment with regards to the treating physician was evaluated.

Results Ninety percent of the patients experienced a decrease of pain score under therapy, only 10 % showed no change. On average there was an improvement in pain score from 7.4 (2–10) before therapy to 3.7 (0–9) at the end of therapy. We observed a weak correlation of –0.22 (p < 0.028) between distribution of drug mixture to the neuroforamen and reduction of pain score. The therapy outcome displayed a dependency regarding the treating physician (p < 0.0084).

Conclusion CT guided periradicular therapy offers good pain reduction in most of the patients. Drug distribution near the affected nerve and treating physician are factors for clinical success.

Key Points:

  • CT-guided periradicular therapy shows a good or very good improvement in the symptoms in 90 % of the treated patients.

  • In addition to technical performance, the treating radiologist is an important parameter determining success.

  • The success of CT-guided treatment is only moderately correlated with an absolute distribution of the drug mixture.

Citation Format

  • Stueckle CA, Talarczyk S, Hackert B et al. CT-guided Interventional Therapy of Back Pain – Predictors of Success in Treatment. Fortschr Röntgenstr 2020; DOI: 10.1055/a-1161-9358



Publication History

Received: 01 February 2020

Accepted: 11 April 2020

Publication Date:
16 July 2020 (online)

© Georg Thieme Verlag KG
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