scholarly journals Interlaminar Versus Transforaminal Epidural Steroids for the Treatment of Subacute Lumbar Radicular Pain: A Randomized, Blinded, Prospective Outcome Study

2011 ◽  
Vol 6;14 (6;12) ◽  
pp. 499-511 ◽  
Author(s):  
Christopher G. Gharibo
Keyword(s):  
Back Pain ◽  
Rating Scale ◽  
Steroid Injection ◽  
Relative Effectiveness ◽  
Radicular Pain ◽  
Physical Exam ◽  
Therapeutic Effects ◽  
Outcome Study ◽  
Lumbar Radicular Pain ◽  
Epidural Steroids

Background: There is uncertainty in the literature over the relative effectiveness of lumbar epidural interlaminar (IL) steroid injection versus transforaminal (TF) steroid injection for lumbar radiculopathy. Most studies to date have been retrospective, or technically focused. Objective: To complete a randomized, blinded, prospective outcome study of the short-term benefit for IL versus TF epidural steroids for the treatment of subacute lumbar radicular pain. Study design: Prospective, randomized, blinded, subacute efficacy trial. Setting: Tertiary care pain management center, major metropolitan city, United States Methods: After institutional review board approval, 42 age-matched patients with similar lower back pain and unilateral radicular symptoms were enrolled and randomized in a patient and evaluating physician blinded trial to IL or TF epidural steroids from 2007 through 2009. Prior to intervention and 10-16 days after injection, each participant was evaluated by questionnaire and physical exam by an independent physician. All injections were performed by the same physician. Thirty-eight participants completed the study, 18 in the IL group and 20 in the TF group. Four participants required a repeat injection, and 2 participants crossed over to the alternative injection type (IL to TF). Results: Overall, physical exam, diagnostic testing, disability, activity, depression measures, and opioid pill use were similar between the 2 groups, both pre-injection baseline and postinjection improvement. In primary outcomes, the post-injection follow-up Numeric Rating Scale (NRS) was more greatly reduced in the TF group. The NRS decreased from 7.0 ± 1.9 to 3.9 ± 3.1 (mean values +/- standard deviation) in the IL group and 6.4 ± 2.1 to 1.7 ± 1.4 in the TF group. The Oswestry Disability Index was reduced from 37.5 ± 12.6 to 19.0 ± 16.7 in the IL group and 38.3 ± 6.4 to 21.6 ± 16.8 in the TF group. In secondary outcomes, the depression scale was reduced from 4.39 ± 3.22 to 2.28 ± 3.20 in the IL group and 4.10 ± 1.94 to 1.65 ± 1.63 in the TF group. Walking tolerance was increased from 8.1 ± 4.6 blocks to 10.6 ± 4.4 in the IL group and 8.9 ± 5.3 blocks to 11.8 ± 4.2 in the TF group. Limitations: The study did not examine long-term outcomes. A single experienced interventionalist performed all injections. Conclusion: Results suggest that patients may experience greater subjective relief, at least initially, from TF epidural steroid injections over IL. However, more objective, and likely subacute, therapeutic effects are similar. Key words: epidural, steroids, interlaminar, transforaminal, lumbar, lumbosacral, radicular, low back pain

scholarly journals Outcome of Transforaminal Epidural Steroid Injection According to the Severity of Lumbar Foraminal Spinal Stenosis

2018 ◽  
Vol 1 (21;1) ◽  
pp. 67-72 ◽  
Author(s):  
Min Cheol Chang, MD Chang
Keyword(s):  
Spinal Stenosis ◽  
Rating Scale ◽  
Steroid Injection ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
University Hospital ◽  
Group A ◽  
Transforaminal Epidural Steroid Injection ◽  
Lumbar Radicular Pain ◽  
Epidural Steroid

Background: Lumbar foraminal spinal stenosis (LFSS) is a common cause of radicular pain in the lower extremities. Transforaminal epidural steroid injection (TFESI) is being used widely for controlling radicular pain induced by LFSS. The efficacy of TFESI has been demonstrated in previous studies. However, no study has evaluated the outcome of TFESI according to the severity of LFSS. Objective: In this study, we evaluated the outcome of TFESI in patients with chronic lumbar radicular pain due to LFSS according to the severity of LFSS by using magnetic resonance imaging (MRI). Study Design: A prospective observational study. Setting: A university hospital. Methods: Sixty patients with chronic lumbar radicular pain due to LFSS were included in this prospective study and received TFESI at our university hospital. Three patients were lost to followup. On the basis of sagittal lumbar MRI findings, we assigned patients with mild to moderate LFSS to group A (n = 31) and those with severe LFSS to group B (n = 26). Pain intensity was evaluated using a numeric rating scale (NRS) before treatment and at 1, 2, and 3 months after treatment. Results: Compared to pretreatment NRS scores, a significant decrease in NRS scores was observed in patients in both groups at 1, 2, and 3 months after treatment (P = 0.000). However, reductions in the NRS scores over time were significantly larger in group A (P = 0.023). Three months after treatment, 27 patients (87.1%) in group A and 11 patients (42.3%) in group B reported successful pain relief (pain relief of ≥ 50%). Limitations: This study had a small number of patients. Conclusions: After TFESI, chronic lumbar radicular pain was significantly reduced regardless of the severity of LFSS, and the effects of TFESI were sustained for at least 3 months after treatment. However, the outcome of TFESI was superior in the group with a mild to moderate degree of LFSS, compared to the group with a severe degree of LFSS. We believe that our study provides useful information for establishing a treatment plan for radicular pain due to LFSS. Key words: Lumbar foraminal spinal stenosis, transforaminal epidural steroid injection, disease severity, magnetic resonance imaging, numeric rating scale, corticosteroids

EFFECTIVENESS OF EPIDURAL STEROID INJECTION FOR THE MANAGEMENT OF CHRONIC LOW BACK PAIN.

2021 ◽  
pp. 52-54
Author(s):  
Ravi Ranjan Singh ◽  
Bharat Singh
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Herniated Lumbar Disc ◽  
Epidural Steroid

INTRODUCTION: Low-back pain is a common clinical presentation of herniated lumbar disc. The incidence of low back pain is high in our country due to difcult working and living environment. The initial treatment of low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a simple, effective and minimally invasive treatment modality. The aim of this study is to assess the effectiveness of epidural steroid injection for low back and radicular pain. MATERIALS AND METHODS :This is a Prospective observational study. It was carried out on the patients presenting with low back pain due to herniated lumbar disc not responding to conservational management and had Magnetic Resonance Imaging (MRI) proven lumbar disc prolapsed at different level. Injection Methyl prednisolone 80 mg and 2 ml of 0.5% bupivacaine was diluted in 8 ml of normal saline and injected into the affected lumbar epidural space. The functional status of the patient and the severity of pain were evaluated before injection and after injection during the follow-up period by using Ostrewy disability index and visual analogue score. RESULTS: Fifty six patients received the epidural steroid injections, among them three patients did not came for regular follow up till six months and six patients required surgery . remaining forty seven were analyzed , among them 27(55.44%) were male and 20(42.55%) were female. The functional status and pain response of the patients were improved signicantly during all the follow-up periods (p < 0.001). The success rate of this study was 83.92%. No major complications were encountered. CONCLUSION:The ESI is a simple, safe, effective and minimally invasive modality for the management of lumbar radicular pain.

scholarly journals Is ultrasound-guided caudal steroid injection effective in the management of lower lumbar radicular pain? A two-center prospective observational study on 150 patients

2020 ◽  
Vol 87 (4) ◽  
pp. 364-365
Author(s):  
François Robin ◽  
Guillaume Coiffier ◽  
Jean-David Albert ◽  
Christelle Darrieutort-Laffite ◽  
Simon Rio ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Steroid Injection ◽  
Radicular Pain ◽  
Ultrasound Guided ◽  
Lumbar Radicular Pain ◽  
Lower Lumbar

scholarly journals Anticonvulsants for the Treatment of Low Back Pain and Lumbar Radicular Pain

2020 ◽  
Vol 27 (8) ◽  
pp. 779-780
Author(s):  
Michael Gottlieb ◽  
Alex Koyfman ◽  
Brit Long
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Radicular Pain ◽  
Low Back ◽  
Lumbar Radicular Pain

Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain

2020 ◽  
Vol 30 (6) ◽  
pp. 3152-3160
Author(s):  
Sylvain Bise ◽  
Benjamin Dallaudiere ◽  
Lionel Pesquer ◽  
Morad Pedram ◽  
Philippe Meyer ◽  
...  
Keyword(s):  
Steroid Injection ◽  
Platelet Rich Plasma ◽  
Radicular Pain ◽  
Ct Guided ◽  
Lumbar Radicular Pain
Sign in / Sign up

Export Citation Format

Share Document