CT-gesteuerte Prolaps-Steroidinjektion: Eine kausale Therapie des bandscheibenprolapsassoziierten Schmerzsyndroms

Purpose: To evaluate the therapeutic benefit of CT-guided steroid injection into disc herniations. Materials and Methods: In 64 patients, 2.5 mg Dexamethasone was injected into a symptomatic disc herniation under CT-guidance. Conservative treatment 3 to 12 months before injection was unsuccessful. Classified as "complete relief', "strong relief', "mild relief" and "no relief" of pain, the change of discomfort and pain was registered at 14 days, 3 months and 6 months after injection while the conservative regimen continued. Results: At 14 days after injection, 36 patients (56%) showed complete relief, 5 strong relief (8%), 12 mild relief (19%) and 11 no relief (17%). At 6 months after injection, 25 patients showed complete relief (39%), 16 strong relief (25%), and 23 no relief (36%). One complicating spondylodiscitis was observed. Conclusion: CT-guided steroid injection into symptomatic disc herniation represents a therapeutic alternative with good therapeutic results. It can be recommended as an alterative to other minimal invasive therapeutic regimens. The disc material acts as reservoir for the drug with good long term depot effect.