Efficacy of therapeutic fluoroscopy-guided lumbar spine interventional procedures

Galhom, Ayman

doi:10.1016/j.clinimag.2013.02.006

Cited by 4 publications

(16 citation statements)

References 58 publications

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“…However, many studies demonstrate lengthy of injection pain relieve up to 6 months. 3,7,12,24 Repeated injection in this study showed no side effect and avoid the patient from excessive oral NSAID intake. Facet joints had two technique for injection either intra-articular or medial branch, but the efficacy of the former has not been proven.…”

Section: Discussionmentioning

confidence: 54%

“…17 In radicular pain, transforaminal epidural is preferred than any other administration root due to proximity to the target tissue, and spread into the anterior epidural where the herniated disc is mostly affected. 4,12,14 Interlaminar epidural injection was evidence level II for short term relieve, and level III (weak) for long term relief. However, strong evidence for treatment for patient with FBSS is still lacking 29 In one study, Jevulder et al, 18 experienced good result when he used transforaminal approach instead of caudal epidural injection.…”

Section: Discussionmentioning

confidence: 99%

“…Facet joints had two technique for injection either intra-articular or medial branch, but the efficacy of the former has not been proven. 12,17,33 In a study of SIJ intervention after failed back, Maigneet al, 23 found a 50% reduction in pain using VAS scale. In FBSS, SIJ pain ranges from 16 % up to 63% in some studies.…”

Section: Discussionmentioning

confidence: 99%

“…The needles were inserted in the medial branch location. 12 Two to four facets medial branches would be injected according to the case. We used to do therapeutic instead of diagnostic block for the patient benefit.…”

Section: Methodsmentioning

confidence: 99%

“…5 The procedure and technique of treatment were determined by using guidelines based on European tests, and practices for the treatment of chronic back pain described in previous work by the same institute. 6,12 In patient with sever anxiety, intravenous administration of midazolam 2mg and fentanyl 100 mcg were used. In all cases, fluoroscopy guidance was used.…”

Section: Methodsmentioning

confidence: 99%

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Therapeutic Interventional Procedures following Failed Back Surgery; Is It Worth it?

Galhom

2016

Egyptian Spine Journal

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Background Data: Treatment of failed back surgery syndrome (FBSS) is challenging to any spine surgeon or pain specialist. Purpose: The study aims to evaluate pain and functional outcome in response to lumbar spine interventional procedures in failed back. Study Design: Prospective non-randomized clinical case study. Patients and methods: Between Jan 2013 to Jan 2016, 35 patients with FBSS were included. Every patient was subjected to history taking, physical examination, and diagnostic imaging. Patients received a fluoroscopy guided lumbar spine procedures according to the failed back cause. A visual analog scale (VAS) for pain intensity, and Oswestry Disability index (ODI) were completed before the intervention maneuverand continued for one year during follow up. Patients were prepared for another intervention or surgery if he didn't respond to the maneuver according to the case. Results: Patients were predominately females (62.9%) with a mean age of 39.74±12.37 years. Clinical and radiological finding revealed; 31.4% canal or foraminal stenosis, 25.8% facet arthropathy, 17.2% epidural scar, 14.3% recurrent disc, and 11.3% degenerative sacroilitis. After intervention procedure, and during 12 months follow up, one way ANOVA test was significant with P=0.001 for both VAS and ODI. Multivariate logistic regression analysis for both VAS and ODI after one year revealed that proper diagnosis and intervention maneuver were the independent factors that affect both

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Therapeutic Interventional Procedures following Failed Back Surgery; Is It Worth it?

Galhom

2016

Egyptian Spine Journal

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The Effectiveness of Transforaminal Versus Caudal Routes for Epidural Steroid Injections in Managing Lumbosacral Radicular Pain

Liu

Zhou

et al. 2016

Medicine

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Epidural steroid injection (ESI) is one of the most commonly used treatments for radiculopathy. Previous studies have described the effectiveness of ESI in the management of radiculopathy. However, controversy exists regarding the route that is most beneficial and effective with respect to the administration of epidural steroids, as both transforaminal (TF) and caudal (C) routes are commonly used.This analysis reviewed studies comparing the effectiveness of TF-ESIs with that of C-ESIs in the treatment of radiculopathy as a means of providing pain relief and improving functionality. This meta-analysis was performed to guide clinical decision-making.The study was a systematic review of comparative studies.A systematic literature search was performed using the PubMed, EMBASE, and Cochrane Library databases for trials written in English. The randomized trials and observational studies that met our inclusion criteria were subsequently included. Two reviewers, respectively, extracted data and estimated the risk of bias. All statistical analyses were performed using Review Manager 5.3.Six prospective and 2 retrospective studies involving 664 patients were included. Statistical analysis was performed utilizing only the 6 prospective studies. Although slight pain and functional improvements were noted in the TF-ESI groups compared with the C-ESI groups, these improvements were neither clinically nor statistically significant.The limitations of this meta-analysis resulted primarily from the weaknesses of the comparative studies and the relative paucity of patients included in each study.Both the TF and C approaches are effective in reducing pain and improving functional scores, and they demonstrated similar efficacies in the management of lumbosacral radicular pain.

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Ultrasound-guided caudal epidural steroid injection in chronic radicular low back pain: short-term electrophysiologic benefits

2020

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Objective: To assess the short-term efficacy of ultrasound-guided caudal epidural steroid injections (ESIs) in improving pain, and nerve function as measured by electrophysiological testing in chronic radicular low back pain. Methods: Patients diagnosed with chronic radicular low back pain were randomized into one of two groups. The injection group (n = 20) underwent a single ultrasound-guided Caudal ESI of 1 ml of 40 mg ml−1 Triamcinolone Acetonide (Kenacort-A), with local anesthetic. The control group (n = 20) underwent a 12-session physiotherapy program. Both groups were evaluated before and 2 weeks after the intervention using visual analog scale for pain and electrophysiological testing comprising peroneal and tibial terminal motor latencies and F-response latencies and chronodispersion. Results: Both groups showed significant pain reduction on the visual analog scale after the intervention. The injection group showed a significant reduction in F wave chronodispersion post-treatment (<0.01). In the control group, there were no significant differences in F wave parameters pre- and post-treatment (p > 0.05). Conclusion: Caudal ESIs were shown to provide short-term improvement of nerve function as evident by improvement in the electrophysiological parameters sensitive to radiculopathy. It was found to be superior to standard physical therapy in this regard. Advances in knowledge: This work shows a novel electrophysiologic evidence of the short-term efficacy ultrasound-guided caudal ESI.

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Efficacy of therapeutic fluoroscopy-guided lumbar spine interventional procedures

Cited by 4 publications

References 58 publications

Therapeutic Interventional Procedures following Failed Back Surgery; Is It Worth it?

Therapeutic Interventional Procedures following Failed Back Surgery; Is It Worth it?

The Effectiveness of Transforaminal Versus Caudal Routes for Epidural Steroid Injections in Managing Lumbosacral Radicular Pain

Ultrasound-guided caudal epidural steroid injection in chronic radicular low back pain: short-term electrophysiologic benefits

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