Effect of Cervical Multifidus Muscle Area on Interlaminar Epidural Steroid Injection Outcomes

Study Overview
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Brief Summary
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Cervical radiculopathy is one of the most important causes of chronic neck pain. Cervical epidural steroid injections including interlaminar approach are frequently used for treatment option in patients that more conservative modalities are ineffective. Paraspinal muscles have an important role in supporting neck movements and providing stability of the cervical spine. The multifidus muscle, located in the deepest part of the neck extensor muscle group, has become the muscle that is frequently emphasized in spinal pain in recent years. In the literature, it has been shown that the multifidus muscle on the affected side is atrophied in patients with cervical radiculopathy. Although many factors are known to be effective on the outcomes of cervical interlaminar epidural injection, there are limited data on the effect of the multifidus muscle area. In this retrospective study, it was planned to investigate the effect of the multifidus muscle area on the results of cervical interlaminar epidural steroid injection.

Official Title
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Can Multifidus Muscle Area Affect Cervical Interlaminar Epidural Steroid Injection Outcomes?

Conditions
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Cervical Radiculopathy

Intervention / Treatment
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* Other: Cervical multifidus muscle area measurement at 3 levels (C4-C5, C5-C6, C6-C7)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with unilateral radicular pain due to cervical disc herniation for at least 3 months Patients with disc herniation level C5-C6 Patients who are unresponsive to other conservative treatments and who have undergone cervical interlaminar epidural steroid injection Exclusion Criteria: Patients with incomplete medical records (absence of MR imaging, incomplete data of 3rd week and 3rd month follow-up periods after cervical interlaminar epidural steroid injection)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| The patients with a significant decrease in pain severity<br>Evaluation will be done separately in the 3rd week and 3rd month follow-up periods of the cervical epidural steroid injection. Numerical rating scale (NRS) will be used to evaluate pain severity. A reduction of at least 50 percent in the NRS score will be considered significant. | Other: Cervical multifidus muscle area measurement at 3 levels (C4-C5, C5-C6, C6-C7)<br>* Cervical multifidus muscle area measurement will be performed from both the side affected by radiculopathy and the unaffected side using the magnetic resonance (MR) imaging. Measurements will be made by two researchers, independent of each other.<br>|
| Patients without significant decrease in pain severity<br>Evaluation will be done separately in the 3rd week and 3rd month follow-up periods of the cervical epidural steroid injection. Numerical rating scale (NRS) will be used to evaluate pain severity. A reduction of at least 50 percent in the NRS score will be considered significant. | Other: Cervical multifidus muscle area measurement at 3 levels (C4-C5, C5-C6, C6-C7)<br>* Cervical multifidus muscle area measurement will be performed from both the side affected by radiculopathy and the unaffected side using the magnetic resonance (MR) imaging. Measurements will be made by two researchers, independent of each other.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cervical multifidus muscle area | Multifidus muscle measurement will be performed at 3 levels (C4-C5, C5-C6, C6-C7) in the MR imaging obtained from the medical records of the participants in both groups and the values will be compared with each other. Difference between muscle areas will be evaluated for statistical significance. | Through study completion, an average of 2 weeks |