Efficacy of cervical epidural steroid injection with or without local anesthetic on pain and disability

Objectives: Cervical epidural injections are frequently applied in the treatment of radicular pain caused by cervical disc herniation. This study aimed to investigate and compare the effectiveness of cervical epidural steroid injection and cervical epidural steroid + bupivacaine injection using Neck Disability Index (NDI) and Visual Analog Scale (VAS) scores.
Methods: A total of 91 patients were included in the study. Patients who received cervical epidural steroid and cervical epidural steroid + bupivacaine were classified as Group I and Group II, respectively. Demographic characteristics, pain duration, and baseline VAS (VAS0) and NDI (NDI0) scores were recorded. Patients were also evaluated at the first and sixth months, and VAS1, NDI1, VAS6, and NDI6 scores were assessed.
Results: Demographic characteristics and mean pain durations of the groups were similar, and VAS and NDI scores did not differ significantly at baseline, the first, and sixth months. Within each group, the VAS6 score was significantly lower than VAS0 (p=0.01) and VAS1 (p=0.01) scores, while the NDI6 score was also significantly lower than NDI0 (p=0.01) and NDI1 (p=0.01) scores in Group I. Similarly, the VAS3 score was significantly lower than VAS0 (p=0.01) and VAS1 (p=0.01) scores, and the NDI3 score was significantly lower than NDI0 (p=0.01) and NDI1 (p=0.01) scores in Group II.
Conclusion: Our findings showed that the combination of epidural steroid + bupivacaine in cervical interlaminar epidural injections yields similar clinical effects to those of steroid alone, providing comparable improvement in functional status.