Comparison of Pain Score Reduction Using Triamcinolone vs. Dexamethasone in Cervical Transforaminal Epidural Steroid Injections

Objective: This study aimed to compare the effectiveness of triamcinolone vs. dexamethasone used in transforaminal epidural steroid injections for the treatment of cervical radiculopathy. Design: This is a retrospective cohort study of patients with cervical radiculopathy who underwent cervical transforaminal epidural steroid injections performed by a single physician from February 2005 through January 2010. Data from the subjects were divided into two groups on the basis of the type of corticosteroid preparation used during treatment. A two-sample t test with equivalent variance was used to compare the effectiveness of dexamethasone to triamcinolone. Results: Triamcinolone (40 mg per injection) was used in 220 subjects during the period of February 2005 through August 2007, with a mean reduction in pain score of 2.33 points on a 10-point scale. Dexamethasone (15 mg per injection) was used in 221 subjects during the period of September 2007 through January 2010, with a mean reduction in pain score of 2.38 points on a 10-point scale. A two-sample F test for variance showed no statistically significant difference in the variance of these two groups. The two-sample t test with equivalent variance showed no statistically significant difference in the mean reduction in pain score between the two groups. Conclusions: The mean reduction in pain score in this set of 441 patients with cervical radiculopathy treated with transforaminal epidural steroid injections was independent of the type of corticosteroid formulation used. Triamcinolone (40 mg) and dexamethasone (15 mg) produced similar benefits as measured by the patients' self-reported pain scores.