Epidural Steroid Injection for Sciatica: An Analysis of 526 Consecutive Cases with Measurements and the Whistle Test

Loy, Tony Tt

doi:10.1177/230949900000800108

Cited by 10 publications

(9 citation statements)

References 48 publications

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“…Excellent to moderate response was observed in 92% of participants, while 8% were with poor results during 6 -month period. This observation is in a accordance with the results of Loy`s study that reported an excellent to good pain alleviation in 93.35% of epidural treated cases 11 .…”

Section: Discussionsupporting

confidence: 93%

“…Although the effect of ECIs declines with time, a few patients had no pain recurrence during their lifetime after first ECI 11 . While some patients get better only after two or sometimes three injections.…”

Section: Discussionmentioning

confidence: 98%

“…As such, ECI will decrease the soft tissue swelling, edema, strain and adhesions on the nerve shaft 10 . As comparing with the newly developed transdermal disc injection, ECI has the advantages of the easiness, minimum invasion, as well as rapidly relieving of symptoms with smallest dosage requirement 11 .…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Sciatica by Interlaminar Epidural Corticosteroid Injections in Mosul City

samman¹,

asaady²

2020

Int. Res. J. Pharm.

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Objective: This study is conducted to evaluate the effectiveness and safety of ECIs in cases of sciatica in Mosul city with the aim of pain alleviation and improving physical performance. Methods: This study was conducted at Al-Salam Teaching Hospital. Patients were well informed of ECIs therapeutic profile. Enrolled patients have sciatic symptoms for at least 3 months prior to the study, inadequately responded to conservative therapy. Patients received a mixture of Methylprednisolone injection 80mg along with Normal saline plus Bupivacaine injection. Patients assessment for lower back pain and radiculopathy on basis of NRS score. The results were categorized as excellent, moderate and poor. Results: Fifty-two patients met the criteria for inclusion, 45 were males and 7 females. Their ages 25-46 years. The disease duration was between 2 months to 4 years. The first symptoms at presentation were pain (100%), paresthesia (25%), radiculopathy (53%), claudication (13%) and limitation in daily activity (46%). Forty-five patients received 1 injection, 3 patients received 2 and 4 received 3 injections. Eighty seven percent of the participants achieved a statistically significant decline in NRS as compared to baseline (P < 0.001). Mild to moderate side effects were developed by 23% of patients immediately after injection. Excellent results were noticed in 52%, moderate in 40% and poor results reported in 8% of cases. Conclusion: ECI is extremely good option for patients with sciatica who failed to respond to conservative therapy. It is safe and effective for patients unfit for surgery, spared patient from surgery, decreases analgesic intake and allows patient to return to work early.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 98%

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Treatment of Sciatica by Interlaminar Epidural Corticosteroid Injections in Mosul City

samman¹,

asaady²

2020

Int. Res. J. Pharm.

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“…Literature indicates that 10–15% of patients with sciatica secondary to a disc herniation undergo surgery, 34 which corresponded with the present findings ( Table 3 ).…”

Section: Discussionsupporting

confidence: 90%

Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation

Nunes

Pontes

Costa

2016

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveSciatic pain secondary to lumbar disc herniation is a complex condition that is often highly limiting. The causes of pain in disc herniation are multifactorial. Two physiopathological mechanisms are involved in discogenic pain: mechanical deformation of nerve roots and a biochemical inflammatory component resulting from contact between the intervertebral disc and neural tissue, by way of the nucleus pulposus. The aim of this study was to evaluate the efficacy and safety of epidural blockade as therapy for bulging lumbar disc herniation.MethodsA clinical study was conducted based on a retrospective and prospective survey. The blockade consisted of interlaminar puncture and bolus drug delivery. The number of procedures varied according to the clinical response, as determined through weekly evaluations and then 30, 90, and 180 days after the final session. A total of 124 patients who received one to five blockades were evaluated.ResultsThe success rate (defining success as a reduction in sciatic pain of at least 80%) was 75.8%.ConclusionThe results demonstrated the therapeutic action of epidural blockade over the short term, i.e. in cases of acute pain, thus showing that intense and excruciating sciatic pain can be relieved through this technique. Because of the multifactorial genesis of sciatica and the difficulties encountered by healthcare professionals in treating this condition, epidural blockade can become part of therapeutic arsenal available. This procedure is situated between conservative treatment with an eminently clinical focus and surgical approaches.

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“…Lumbar epidural steroid applications can be made with interlaminar, transforaminal, or caudal methods. Different results have been reported in the literature related to the efficacy of these methods [13,[19][20][21][22]. It has been reported in studies that applications of lumbar epidural injection made under fluoroscopy or CT have achieved effective pain palliation using less medication and with reduced complication rates [23,24].…”

Section: Discussionmentioning

confidence: 99%

Effect of Body Mass Index in Patients Administered Epidural Steroid Injection for Back Pain

Baysal¹,

Baysal²,

Erkılınç³

et al. 2016

Ann Clin Anal Med

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ÖzetAmaç: Bel ağrısı nedeniyle medikal ve fizik tedavi uygulanmış fakat bel ağ-rısı şikayetleri devam eden obez ve obez olmayan hastalarda, epidural steroid enjeksiyonu (ESİ) uygulamasının etkinliğini araştırmayı amaçladık. Gereç ve Yöntem: En az 6 aydır devam eden bel ve bacak ağrısı şikayetleri nedeniyle Algoloji polikliniğine başvuran, tek seviyeli disk patolojisi saptanan ve epidural steroid enjeksiyonu planlanan 31-73 yaşları arasında 119 hasta ça-lışmaya dahil edildi. Hastalar obez (BKİ≥30kg/m2) ve obez olmayan (BKİ<30 kg/m2) olarak iki gruba ayrıldı. 48 hasta obez, 71 hasta obez olmayan olarak değerlendirildi. ESİ uygulamasından sonraki 1.ay, 6.ay ve 12.ay' da ağrı şiddetleri VAS ile değerlendirilirken, fonksiyonel durumları Oswestry skalası ile değerlendirildi. Bulgular: Tüm hastalarda 1.ESİ uygulamasından 30 gün, 6 ay ve 12 ay sonra ölçülen VAS ve Oswestry skoru değerlerinde tedavi önce-sine göre istatistiksel olarak anlamlı iyileşme saptandı (p<0.001). Vas 1 ≥ 5 olan 56 hastaya ikinci enjeksiyon yapıldı. 2. enjeksiyon yapılan obez ve obez olmayan hasta grupları arasında istatiksel bir fark yoktu(p=0,597). 2. enjeksiyon yapılan hem obez, hem de obez olmayan hasta grubunda ağrı palyasyonunda ve fonksiyonel iyileşmede belirgin olarak başarı elde edilmişken, bu iki grup arasında istatiksel fark yoktu. Tartışma: Analjezik ve fizik tedavi yön-temleri uygulanmasına rağmen yeterince ağrı palyasyonu ve fonksiyonel iyileşme sağlanamayan tek seviye lomber diskopatili hastalarda, ESI uygulamasının obez ve obez olmayan hastalarda etkin bir tedavi yöntemi olduğu-nu düşünmekteyiz. Anahtar KelimelerBel Ağrısı; Epidural Steroid Enjeksiyon; Obezite; Oswestry Skalası Abstract Aim: The aim is to investigate the efficacy of epidural steroid injection applied for lumbar discopathy pain to obese and non-obese patients with continuing complaints of back pain, despite the application of medical treatment and physical therapy. Material and Method: The study included 119 patients aged 31-73 years who presented at the Algology Clinic with complaints of back and leg pain which had been ongoing for at least 6 months and with single level disc pathologies, and for whom epidural steroid injection was planned. The patients were separated into 2 groups as obese (BMI ≥ 30kg/ m2) and non-obese (BMI<30kg/m2); 48 patients were evaluated as obese and 71 as non-obese. Pain palliation in obese and non-obese patient groups was compared using early stage and 1st year VAS scores and the functional status was evaluated with the Oswestry Scale. Results: In all patients there was found to be a statistically significant fall in the VAS and Oswestry values at 30 days, 6 months, and 12 months after the first ESI compared to the pre-treatment values (p<0.0001). A second injection was applied to 56 patients with VAS ≥ 5. There was no statistical difference between obese and non-obese patients who were administered a second injection (p=0.597). There was a significant palliation of pain and functional improvement in both obese and non-obese patient group...

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Epidural Steroid Injection for Sciatica: An Analysis of 526 Consecutive Cases with Measurements and the Whistle Test

Cited by 10 publications

References 48 publications

Treatment of Sciatica by Interlaminar Epidural Corticosteroid Injections in Mosul City

Treatment of Sciatica by Interlaminar Epidural Corticosteroid Injections in Mosul City

Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation

Effect of Body Mass Index in Patients Administered Epidural Steroid Injection for Back Pain

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