Die epidurale Injektionsbehandlung mit Lokalanästhetikum versus Kortison beim chronischen lumbalen Nervenwurzelkompressionssyndrom: eine prospektive Studie

Teske, Wolfram; Zirke, Sonja; Trippe, C.; Krämer, J.; Willburger, R. E.; Schott, Cordelia; Theodoridis, Theodoros; Beer, A.-M.; Molsberger, Albrecht

doi:10.1055/s-0029-1185525

Cited by 12 publications

(3 citation statements)

References 11 publications

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“…The research of our group could reduce the drug dose to a value of 5 mg triamcinolone [1]. Local anaesthetics showed good results using this technique, too [8]. …”

Section: Discussionmentioning

confidence: 99%

Anatomical and surgical study of volume determination of the anterolateral epidural space nerve root L5/S1 under the aspect of epidural perineural injection in minimal invasive treatment of lumbar nerve root compression

et al. 2010

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Herniated intervertebral disc causes in a great number of cases of lumbar nerve root compression, especially in the segment L5/S1. Other reasons responsible for stress to the lumbar spinal root are the spinal canal stenosis and the postdiscotomy syndrome. For patients without neurological deficiencies, the conservative treatment includes different epidural injection techniques. Steroids are often applied. A specific injection technique needing only a small drug amount is the epidural perineural approach using a special two-needle technique. The anatomical spaces of the nerve roots have received little attention in therapy. We have determined the anterolateral epidural space nerve volume of the nerve root L5/S1, and compared the data collected in an anatomical study with operative measurements during discectomy. The volume determination in the human cadavers was performed with liquid silicone filling the anterolateral space after dissection. The in vivo measurements were performed during surgery at the site of the anterolateral space after discectomy. The anatomical studies showed us a mean value volume of 1.1 ml. The surgical volume determinations result in a mean volume of 0.9 ml. A better understanding of the anterolateral epidural space may allow a reduction of the injection volume in the conservative nerve root compression treatment, especially using the epidural perineural technique, avoiding the risk of side effects of high doses of steroids.

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“…The research of our group could reduce the drug dose to a value of 5 mg triamcinolone [1]. Local anaesthetics showed good results using this technique, too [8]. …”

Section: Discussionmentioning

confidence: 99%

Anatomical and surgical study of volume determination of the anterolateral epidural space nerve root L5/S1 under the aspect of epidural perineural injection in minimal invasive treatment of lumbar nerve root compression

et al. 2010

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“…The injections are lumbar spinal nerve root analgesia (LSPA) of the affected nerve root in ‘freehand technique’ 8 Additional treatment consisted of 1 injection of the facette joints under x-ray and 1 epidural injections in ‘loss-of-resistance technique’ per stay. LSPA injections only contained 0.5% Scandicaine, whereas epidural injections and facette joint injection also contained triamcinolone 40 mg ( Table 2 ) 3 9 10 11 . In cases of good effect the injection was repeated once.…”

Section: Methodsmentioning

confidence: 99%

Prospective medium-term results of multimodal pain management in patients with lumbar radiculopathy

Benditz

Madl

Loher

et al. 2016

Sci Rep

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Lumbar radiculopathy is one of the most common diseases of modern civilisation. Multimodal pain management (MPM) represents a central approach to avoiding surgery. Only few medium-term results have been published in the literature so far. This study compared subjective and objective as well as anamnestic and clinical parameters of 60 patients who had undergone inpatient MPM because of lumbar radiculopathy before and 1 year ±2 weeks after treatment. The majority of patients were very satisfied (35%) or satisfied (52%) with the treatment outcome. Merely 8 patients commented neutrally and none negatively. The finger-floor distance had decreased significantly (p < 0.01), and 30 patients (50%) had shown improved mobility of the spine after therapy. The need for painkillers had also been significantly reduced after 1 year. The arithmetical average of pain on a visual analogue scale was 7.21 before treatment, which had significantly decreased to 3.58 at follow-up (p < 0.01). MPM is an effective approach for treating lumbar radiculopathy by mechanical nerve root irritation. Therefore, in the absence of an absolute indication for surgery or an absolute contradiction for MPM, patients should first be treated with this minimally invasive therapy.

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“…Einige prospektive doppelblind randomisierte Studien konnten keinen eindeutigen Vorteil der kombinierten Lokalanästhetika-Kortikoid-Injektion gegenüber der alleinigen Lokalanästhetika-Injektion nachweisen[5,6]. Darüber hinaus können diagnostische Infiltrationen zur Eingrenzung der pathologisch-anatomischen Strukturen angewandt werden, die den Schmerz im Wesentlichen oder ausschließlich generieren sollen.…”

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Diagnostik und Therapie der degenerativ veränderten Lendenwirbelsäule

Heider

Siepe

2016

Klinikarzt

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Chronische R?ckenschmerzen, hervorgerufen durch degenerative Ver?nderungen an der Wirbels?ule, sind in den Industrienationen der westlichen Welt weit manifestiert und ein allgegenw?rtiges Problem im ?rztlichen Alltag. Das Fundament einer erfolgreichen Behandlung bilden dabei eine fundierte und systematische Diagnostik sowie die sich daran anschlie?ende gezielte Indikationsstellung zur Auswahl und Einleitung des korrekten und erfolgversprechenden Therapieregimes. Dabei k?nnen mehr als 80?% der Patienten mit akuter R?ckenschmerzsymptomatik durch eine gezielte konservative Therapie erfolgreich behandelt werden. Lediglich bei manifesten neurologischen Defiziten und/oder Versagen der konservativen Therapie erzielen operative Verfahren ihre Wirksamkeit und Berechtigung. Der zweite Teil des Artikels gibt eine ?bersicht ?ber aktuell g?ngige operative Therapieverfahren bei degenerativen Erkrankungen der Lendenwirbels?ule.

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Die epidurale Injektionsbehandlung mit Lokalanästhetikum versus Kortison beim chronischen lumbalen Nervenwurzelkompressionssyndrom: eine prospektive Studie

Abstract: The advantage of a combined injection of local anaesthetics and cortisone versus a injection of local anaesthetics alone in epidural-peridural technique in the inpatient treatment of the chronic lumbar spine root compression syndrome could not be detected.

Cited by 12 publications

References 11 publications

Anatomical and surgical study of volume determination of the anterolateral epidural space nerve root L5/S1 under the aspect of epidural perineural injection in minimal invasive treatment of lumbar nerve root compression

Anatomical and surgical study of volume determination of the anterolateral epidural space nerve root L5/S1 under the aspect of epidural perineural injection in minimal invasive treatment of lumbar nerve root compression

Prospective medium-term results of multimodal pain management in patients with lumbar radiculopathy

Diagnostik und Therapie der degenerativ veränderten Lendenwirbelsäule

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