DOI: https://doi.org/10.14710/jai.v0i0.73464

Interlaminar Cervical Epidural Non-Particulate Steroid Injection for Acute Cervical Radicular Pain: A Case Study of Clinical Effectiveness

1Anesthesiology and Intensive Care Department, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Daerah Istimewa Yogyakarta, Indonesia – Academic Hospital Universitas Gadjah Mada, Daerah Istimewa Yogyakarta, Indonesia, Indonesia

2Faculty of Medicine, Public Health, and Nursing (FK-KMK) Universitas Gadjah Mada, Indonesia

3Anesthesiology and Intensive Care Department, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Daerah Istimewa Yogyakarta, Indonesia – RSUP Dr. Sardjito , Daerah Istimewa Yogyakarta, Indonesia, Indonesia

Received: 21 May 2025; Revised: 29 Aug 2025; Accepted: 24 Oct 2025; Available online: 24 Oct 2025.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

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Abstract

Background: Cervical radicular pain is pain that arise at upper extremities caused by ectopic activities of afferent nociceptive or radix medulla spinalis or another mechanism. The management depends on the onset and etiology. The pain intervention which can be done is Interlaminar Cervical Epidural Steroid Injection (ICESI), Transforaminal Epidural Steroid Injection (TFSI), thermal radio frequency (TRF), pulse radio frequency (PRF) at dorsal radix with transforaminal approach, Spinal Cord Stimulation (SCS), or surgery. Each modalities have different beneficial and side effects. The application depends on pain pathophysiology, imaging, and the human resources. The successfulness of interlaminar cervical epidural steroid injection is still debatable. This case report aimed to evaluate the successfulness of interlaminar cervical epidural steroid injection for cervical radicular pain.

Case: A woman, 71 years old, suffered from neck pain with radicular pain along the arm, until palm, thumbs, and index finger both right and left side. The patient reported persistent pain predominantly in the palms, with an intensity of 7 out of 10 on the Numeric Rating Scale (NRS). She felt the pain for 2 months, and didn’t relieve with pharmacotherapy and physiotherapy. The cervical Magnetic Resonance Imaging (MRI) showed entrapment at radix C6. Patient was advised to undergo operative procedure, but the patient refused it, and was offered interlaminar cervical epidural steroid injection.

Conclusion: Interlaminar cervical epidural steroid injection is effective for cervical radicular pain

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Keywords: cervical radicular pain; acute; pain intervention; epidural steroid injection; interlaminar
Funding: none

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Article Info
Section: Case Reports
Language : EN
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  1. Van Zundert J, Hartrick C, Patijn J, Huygen F, Mekhail N, van Kleef M. Evidence-Based Interventional Pain Medicine According to Clinical Diagnoses. Pain Pract. 2011;11(5):423–9
  2. David J. Cervical Radiculopathy: Nonoperative Management of Neck Pain and Radicular Symptoms. Am Fam Physician [Internet]. 2010;81(1):33–40. Available from: https://www.aafp.org/afp/2010/0101/p33.html
  3. Iyer S, Kim HJ. Cervical radiculopathy. Curr Rev Musculoskelet Med. 2016;9(3):272–80
  4. Cohen SP, Hayek S, Semenov Y, Pasquina PF, White RL, Veizi E, et al. Epidural steroid injections, conservative treatment, or combination treatment for cervical radicular pain: a multicenter, randomized, comparative-effectiveness study. Anestesiology. 2014;121(5):1045–55
  5. Lee DG, Ahn SH, Lee J. Comparative effectivenesses of pulsed radiofrequency and transforaminal steroid injection for radicular pain due to disc herniation: A prospective randomized trial. J Korean Med Sci. 2016;31(8):1324–30
  6. Bicket MC, Chakravarthy K, Chang D, Cohen SP. Epidural steroid injections: an updated review on recent trends in safety and complications. Pain Manag. 2015;5(2):129–46
  7. Yang L, Huang Y, Ma J, Li Z, Han R, Guo G, et al. Clinical Outcome of Pulsed-Radiofrequency Combined With Transforaminal Epidural Steroid Injection for Lumbosacral Radicular Pain Caused by Distinct Etiology. Front Neurosci. 2021;15(July):1–6
  8. International Association for The Study of Pain. Classification of Chronic Pain, Second Edition (Revised) [Internet]. 2021. Available from: https://www.iasp-pain.org/publications/free-ebooks/classification-of-chronic-pain-second-edition-revised/
  9. Diwan SA, Manchikanti L, Benyamin RM, Bryce DA, Geffert S, Hameed H, et al. Effectiveness of cervical epidural injections in the management of chronic neck and upper extremity pain. Pain Physician. 2012;15(4):405–34
  10. Manchikanti L, Falco FJE, Diwan S, Hirsch JA, Smith HS. Cervical radicular pain: The role of interlaminar and transforaminal epidural injections. Curr Pain Headache Rep. 2014;18(1)
  11. Huston CW. Cervical epidural steroid injections in the management of cervical radiculitis: Interlaminar versus transforaminal. A review. Curr Rev Musculoskelet Med. 2009;2(1):30–42
  12. Scanlon GC, Moeller-Bertram T, Romanowsky SM, Wallace MS. Cervical transforaminal epidural steroid injections: More dangerous than we think? Spine (Phila Pa 1976). 2007;32(11):1249–56
  13. Hashemi M, Dadkhah P, Taheri M, Dehghan K, Valizadeh R. Cervical Epidural Steroid Injection: Parasagittal versus Midline Approach in Patients with Unilateral Cervical Radicular Pain; A Randomized Clinical Trial. Bull Emerg Trauma. 2019;7(2):137–43
  14. Sim JH, Park H, Kim Y, Shin JW, Leem JG, Cho HS, et al. Comparative effectiveness of parasagittal interlaminar and transforaminal cervical epidural steroid injection in patients with cervical radicular pain: A randomized clinical trial. Pain Physician. 2021;24(2):117–25
  15. Orduña-Valls JM, Cedeno DL, Nebreda-Clavo C, Tornero-Tornero C, Álvarez-Escudero J, Martinez MF, et al. Microscopic study of injectable steroids: Effects of postmixing time on particle aggregation. Pain Physician. 2020;23(4):E417–24
  16. Dinescu L, Shmargun M, Reddy A, Vivek Mukherjee. Steroids and Corticosteroids [Internet]. 2021 [cited 2022 Jan 9]. Available from: https://now.aapmr.org/steroids-and-corticosteroids/
  17. El-Yahchouchi C, Geske JR, Carter RE, Diehn FE, Wald JT, Murthy NS, et al. The noninferiority of the nonparticulate steroid dexamethasone vs the particulate steroids betamethasone and triamcinolone in lumbar transforaminal epidural steroid injections. Pain Med (United States). 2013;14(11):1650–7
  18. Feeley IH, Healy EF, Noel J, Kiely PJ, Murphy TM. Particulate and non-particulate steroids in spinal epidurals: a systematic review and meta-analysis. Eur Spine J. 2017;26(2):336–44
  19. Stephens AR, Bender NR, Snyder JM, Patel RK, El-Hassan R. Evaluating the effectiveness of interlaminar epidural steroid injections for cervical radiculopathy using PROMIS as an outcome measure. Interv Pain Med [Internet]. 2024;3(100528):1–5. Available from: https://doi.org/10.1016/j.inpm.2024.100528
  20. Purushothaman AM, Pujari VS, Kadirehally NB, Bevinaguddaiah Y, Reddy PR. A prospective randomized study on the impact of low-dose dexamethasone on perioperative blood glucose concentrations in diabetics and nondiabetics. Saudi J Anaesth. 2018;12(2):198–203
  21. Yasir M, Goyal A, Bansal P, Sidharth Sonthalia. Corticosteroid Adverse Effects [Internet]. StatPearls Publishing; 2021. Available from: https://pubmed.ncbi.nlm.nih.gov/30285357/
  22. Waterbrook AL, Balcik BJ, Goshinska AJ. Blood Glucose Levels After Local Musculoskeletal Steroid Injections in Patients With Diabetes Mellitus: A Clinical Review. Sports Health. 2017;9(4):372–4

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