الفهرس 
Anatomy of Cervical SpineOnly 14 pages are availabe for public view
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Abstract
In this thesis study we have reviewed the literature related to cervical epidural injection, including: anatomy of cervical spine, physiology of pain, pathology of cervical disc disease, different techniques of epidural injection, and possible complications. Brachialgia presents as pain in a dermatomal distribution. This frequently represents compression of an exiting cervical nerve root by either a herniated disk or a degenerative cervical spondylotic change. Most patients will improve with nonoperative treatment, and a small percentage will require further diagnostic evaluation and ultimately surgical intervention. Cervical epidural steroid injections (CESIs) are now considered as an integral part of the non surgical management of radicular pain. The interlaminar approach is the most commonly used approach. The interlaminar ESI has the advantage of providing multilevel and bilateral spread of the injectated materials in the epidural space that may make the interlaminar technique the more logical approach in a patient with multilevel spinal disease. In this study 60 patients with brachialgia. The included patients were divided into two groups, group (A) included thirty patients were given conservative treatment only, as a control group. The second group (B) had cervical epidural injection in addition to the standard conservative treatment and those with no response to epidural injection, received oral steroids. In all of patients of the two groups, the main complaint was neck pain with Lt. sided brachialgia or bilateral brachialgia only two patients had pure Rt. sided brachialgia. Response to treatment either by medications (group A) or by injection (group B) was measured by VAS; the first before treatment (initial) then at 2 weeks, 4 weeks and 6 weeks (final), then PCI was measured according to the following formula: PCI % = VAS(initial)-VAS(final)/VAS(initial)×100. Mean PCI of group (A) was 61.03±9.43 and for group (B) was 78.50±22.77, which was highly significant as P-value <0.001. In conclusion: This study showed a statistically significant efficacy of the treatment of brachialgia with single epidural injection of corticosteroids plus local anesthetic agent in patients with cervical disc disease and so epidural injection can probably help some patients to continue the non surgical treatment.