Comparative effectiveness of lumbar epidural steroid injections using particulate vs. non-particulate steroid: an intra-individual comparative study

Kim, Ji Young; Lee, Joon Woo; Lee, Geun Young; Lee, Eugene; Yoon, Chang Jin; Kang, Heung Sik

doi:10.1007/s00256-015-2277-3

Cited by 20 publications

(16 citation statements)

References 27 publications

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“…Kim et al [43] examined dexamethasone and triamcinolone for lumbar ESI performed via 3 different approaches: ILESI, TFESI, and caudal ESI. The intraindividual comparison study included 162 patients with lumbar radiculopathy secondary to stenosis or disk herniation.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of the Efficacy of Particulate Versus Nonparticulate Corticosteroids in Epidural Injections

Mehta

Syrop

Singh

et al. 2016

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Section: Resultsmentioning

confidence: 99%

Systematic Review of the Efficacy of Particulate Versus Nonparticulate Corticosteroids in Epidural Injections

Mehta

Syrop

Singh

et al. 2016

PM&R

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“…In lumbar transforaminal ESI, a nonparticulate steroid should be used for the initial injection, but there are situations in which particulate steroids could be used (55). Although early studies suggested that particulate steroids were superior to nonparticulate steroids in the duration of pain relief, recent studies suggest inconsistent results regarding a longer duration of pain relief for particulate steroids (56)(57)(58).…”

Section: Particulate Steroid Injectionmentioning

confidence: 99%

Fluoroscopically Guided Epidural Injections of the Cervical and Lumbar Spine

Shim

Lee

et al. 2017

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Advances in imaging and the development of injection techniques have enabled spinal intervention to become an important tool in managing chronic spinal pain. Epidural steroid injection (ESI) is one of the most widely used spinal interventions; it directly delivers drugs into the epidural space to relieve pain originating from degenerative spine disorders-central canal stenoses and neural foraminal stenoses-or disk herniations. Knowledge of the normal anatomy of the epidural space is essential to perform an effective and safe ESI and to recognize possible complications. Although computed tomographic (CT) or combined CT-fluoroscopic guidance has been increasingly used in ESI, conventional fluoroscopic guidance is generally performed. In ESI, drugs are delivered into the epidural space by interlaminar or transforaminal routes in the cervical spine or by interlaminar, transforaminal, or caudal routes in the lumbar spine. Epidurography is usually performed before drug delivery to verify the proper position of the needle in the epidural space. A small amount of contrast agent is injected with fluoroscopic guidance. Familiarity with the findings on a typical "true" epidurogram (demonstrating correct needle placement in the epidural space) permits proper performance of ESI. Findings on "false" epidurograms (demonstrating incorrect needle placement) include muscular staining and evidence of intravascular injection, inadvertent facet joint injection, dural puncture, subdural injection, and intraneural or intradiscal injection. RSNA, 2016 An earlier incorrect version of this article appeared online. This article was corrected on December 22, 2016.

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“…A prospective study from 2010 randomized 106 patients to receive DSP or TA before lumbar transforaminal ESI and concluded that TA was more effective than DSP in treating lumbar radiculopathy when assessed using the visual analog score but was statistically similar to DSP using the McGill Pain Questionnaire or the Oswestry Disability Index [87]. A retrospective study involving 139 lumbar ESIs (interlaminar, transforaminal, or caudal) included patients who received TA initially and DSP subsequently [88]. On the basis of telephone interviews 6 months after DSP injection, the study reported that patients were significantly more satisfied with TA injections compared with DSP injections.…”

Section: Efficacy Of Particulate Versus Nonparticulate Corticosteroidsmentioning

confidence: 99%

Spine Injectables: What Is the Safest Cocktail?

MacMahon

Huang

Palmer

2016

American Journal of Roentgenology

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Nonparticulate preparations, such as dexamethasone, are safer but have shorter-lived antiinflammatory effects. Local anesthetics are often mixed with corticosteroids in pain management procedures. Although everyday risks are minimal, injection techniques should take into account neural and cardiac toxicities. In this article, we discuss the potential for serious adverse events associated with injected medications. We review the current literature to make conclusions on medication combinations that balance safety and efficacy.

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Comparative effectiveness of lumbar epidural steroid injections using particulate vs. non-particulate steroid: an intra-individual comparative study

Abstract: The relative satisfaction with ESI_TRIAM was significantly better than that with ESI_DEXA in the same patient, and the injection-free interval after ESI_TRIAM was significantly longer than that after ESI_DEXA.

Cited by 20 publications

References 27 publications

Systematic Review of the Efficacy of Particulate Versus Nonparticulate Corticosteroids in Epidural Injections

Systematic Review of the Efficacy of Particulate Versus Nonparticulate Corticosteroids in Epidural Injections

Fluoroscopically Guided Epidural Injections of the Cervical and Lumbar Spine

Spine Injectables: What Is the Safest Cocktail?

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