Association of contrast spread pattern and clinical outcomes in cervical interlaminar epidural injection

Overall, 60% of the participants experienced more than 50% pain reduction in NRS pain scores. Statistically significant difference was discovered in patients with longer duration of the symptoms, cervical pathology higher than C4-5 level, and moderate to severe central stenosis. Variable findings were assessed on the clinical result of CILESI by different contrast spread patterns. Only the contrast spread pattern of grade 3 resulted to have notable success rate whereas the contribution to success could not be made from the grade 1 and 2. The grade 4 rather resulted significantly unsuccessful result. Univariate analysis demonstrated that factors associated with unsuccessful outcomes were the longer duration of the symptoms, higher pathological lesion above the C4-5 level, moderate to severe central stenosis, and the contrast spread pattern of grade 4 (Table 2). On further multivariable analysis, the duration of the symptoms, high grade of central stenosis, and the grade 4 dye dispersion on epidurography were to be linked to unsuccessful prognosis. Primary poor prognostic factor was analyzed to be the CILESI with the contrast only sread to the dorsal epidural place and no further. Grade 4 spread pattern yielded nearly 9 times worse outcomes that grade 1.