Epidural Steroid Injection in the Management of Patients with Subacute or Chronic Low Back Ache with Radiculopathy due to Herniated Disc

Gul, Irfan; Kirmani, Tabish Tahir; Bhat, Mohammad S.; Gull, Zahid Andleeb

doi:10.21276/ijcmr.2018.5.6.16

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…All of these events were mild and transient and subsided with conservative therapy. These observations is agree with other studies carried out by Madhukar et al, Gul et al and Runu et al 16,24,25 .…”

Section: Discussionsupporting

confidence: 94%

“…So that, ECI provides analgesia for a variable duration during which the patient be able to practice rehabilitation exercises 23 . Methyl prednisolone was used in this study for its anti-inflammatory effects and for its long acting duration 24 . Moreover, it was found that the existence of methyl prednisolone in epidural gap suppresses transmission in unmyelinated C fibres, the major nociceptive pathway 25 .…”

Section: Discussionmentioning

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: 94%

Section: Discussionmentioning

confidence: 99%

Treatment of Sciatica by Interlaminar Epidural Corticosteroid Injections in Mosul City

samman¹,

asaady²

2020

Int. Res. J. Pharm.

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Effectiveness of Epidural Injection Under Flouroscopic Guidance in Chronic Low Back Pain With Bilateral Lower Limb Radiculopathy

Sidhdhapuria¹,

Patel²,

Mehta³

et al. 2022

ijsr

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Introduction: Chronic Low back pain with lumbosacral radiculopathy is one of the most common complain amongst patient in any orthopaedic out patient department . Therapeutic management of this problem is still a big task. Lumbar intervertebral disc herniation stands out to be most common cause , others include spinal stenosis , disc degeneration, post lumbar surgery syndrome. Epidural injections are used in patients with chronic low back pain with radiculopathy not relieved by conservative management. The aim of the study was to check the efcacy of uoroscopy guided epidural Injection of local anaesthetic and steroid in chronic low back pain with bilateral lower limb radiculopathy and compare the results with existing data of blind epidural injection without uoroscopic control. Materials And Method: The study was conducted among 52 patients visiting our out patient department at SMIMER hospital with complain of chronic low back pain bilateral lower limb radiculopathy not responding to conservative treatment. Outcomes were evaluated on the basis of pain relief (VAS score was used pre and post procedure), improvement in Oswestry low back disability score ,short term relief -6 months and long term relief > 6 months. Secondary outcome measure was functional status , psychological status and return to work. Results: In our study of 52 patients with chronic low back pain with bilateral lower limb radiculopathy not responding to medications, epidural injection was given under uoroscopic guidance after which 90.3%(47 patients) reported signicant improvement with mean VAS score improvement to 1.89 post procedure from mean score of 8.89 post procedure. Oswestry low back disability score decreased post procedure to 9% from pre-procedure score of 56.8%. No complications were reported in our study group. Conclusion: Epidural steroid injection is an effective treatment for the patients with chronic low back pain with bilateral lower limb radiculopathy not responding to therapeutic treatment. It is cost effective, safe and minimizes use of analgesics, allows early return to work and prevents or postpones surgical intervention needed for the same. Fluoroscopy adds on the benet of precision and accuracy of the epidural space for injection leading to increased efcacy and no requirement of sequential dosage as in epidural injection without uoroscopy due to lack of accuracy in that.

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Epidural Steroid Injection in the Management of Patients with Subacute or Chronic Low Back Ache with Radiculopathy due to Herniated Disc

Cited by 2 publications

References 13 publications

Treatment of Sciatica by Interlaminar Epidural Corticosteroid Injections in Mosul City

Treatment of Sciatica by Interlaminar Epidural Corticosteroid Injections in Mosul City

Effectiveness of Epidural Injection Under Flouroscopic Guidance in Chronic Low Back Pain With Bilateral Lower Limb Radiculopathy

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