Clinical Relevance of Epidural Steroid Injections on Lumbosacral Radicular Syndrome-related Symptoms

Bruijn, Thomas M de; Groot, Ingrid B de; Miedema, Harald S.; Haumann, Johan; Ostelo, Raymond

doi:10.1097/ajp.0000000000000997

Cited by 1 publication

(1 citation statement)

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“…There appears to be wide variation in response to ESIs, with some patients improving to such a degree that spinal surgery is avoided, while others do not improve 7 11–14. Little is known about which factors predict the outcome from ESIs: patient characteristics, clinical assessment findings, imaging findings or other test results.…”

Section: Introductionmentioning

confidence: 99%

Predictors of outcome in sciatica patients following an epidural steroid injection: the POiSE prospective observational cohort study protocol

Stynes,

Snell,

Riley

et al. 2023

BMJ Open

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IntroductionSciatica can be very painful and, in most cases, is due to pressure on a spinal nerve root from a disc herniation with associated inflammation. For some patients, the pain persists, and one management option is a spinal epidural steroid injection (ESI). The aim of an ESI is to relieve leg pain, improve function and reduce the need for surgery. ESIs work well in some patients but not in others, but we cannot identify these patient subgroups currently. This study aims to identify factors, including patient characteristics, clinical examination and imaging findings, that help in predicting who does well and who does not after an ESI. The overall objective is to develop a prognostic model to support individualised patient and clinical decision-making regarding ESI.MethodsPOiSE is a prospective cohort study of 439 patients with sciatica referred by their clinician for an ESI. Participants will receive weekly text messages until 12 weeks following their ESIand then again at 24 weeks following their ESI to collect data on leg pain severity. Questionnaires will be sent to participants at baseline, 6, 12 and 24 weeks after their ESI to collect data on pain, disability, recovery and additional interventions. The prognosis for the cohort will be described. The primary outcome measure for the prognostic model is leg pain at 6 weeks. Prognostic models will also be developed for secondary outcomes of disability and recovery at 6 weeks and additional interventions at 24 weeks following ESI. Statistical analyses will include multivariable linear and logistic regression with mixed effects model.Ethics and disseminationThe POiSE study has received ethical approval (South Central Berkshire B Research Ethics Committee 21/SC/0257). Dissemination will be guided by our patient and public engagement group and will include scientific publications, conference presentations and social media.

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Section: Introductionmentioning

confidence: 99%