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Pain and Spine Medicine

The Impact of Cervical Transforaminal Epidural Steroid Injections on Cervical Radiculopathy in the Setting of Cervical Foraminal Stenosis Versus Cervical Disc Herniation

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 10
Disclosure(s):
Ashlee Hiller, Other: No financial relationships to disclose
Zeinab Mohamed, PhD: No financial relationships to disclose
Ali Shakir, MD: No financial relationships to disclose
Background and/or Objectives: To determine if the pain score reduction following a cervical transforaminal epidural steroid injection (TF-ESI) for the management of cervical radicular pain is different for subjects with radiculopathy due to cervical foraminal stenosis, as compared to subjects with cervical disc herniation.

Design: This was a retrospective cohort study. Data from subjects who underwent cervical TF-ESI were divided into 2 groups based on whether the etiology of their cervical radiculopathy was due to cervical foraminal stenosis or cervical disc herniation. Group determination was based on their cervical spine MRI study findings. A one-way analysis of variance (ANOVA) was used to assess the relationship between etiology of cervical radiculopathy and numerical pain score reduction following cervical TF-ESI.

Setting : All procedures were performed under fluoroscopic guidance in a single community-based physical medicine and rehabilitation clinic.

Participants : 208 patients who underwent their first cervical TF-ESI under fluoroscopic guidance for the management of their unilateral cervical radicular pain between 08/02/2019 and 08/31/2024.

Interventions: Not applicable.

Main Outcome Measures: Change in self-reported numerical pain score from initial pain score before procedure and pain score one month following procedure.

Results: Of the total subjects, 135 subjects had cervical foraminal stenosis and 73 subjects had cervical disc herniation. Stenosis subjects had a mean pre-procedure pain score of 6.53 (SD=1.55) and a mean reduction in pain score following the procedure of 3.36 (SD=1.83). Herniation subjects had a mean pre-procedure pain score of 6.60 (SD=1.75) and a mean reduction in pain score following procedure of 3.36 (SD=1.86). The one-way ANOVA analysis revealed a trend toward significance but did not reach conventional statistical significance (F(1,206) = 0.001, p = 0.976).

Conclusions: The effectiveness of cervical TF-ESI was consistent across diagnostic categories.