Prospective randomised single blind study of epidural steroid injection comparing triamcinalone acetonide with methylprednisolone acetate

Anwar, Anis Irawan; Zaidah, I.; Rezaei, Rozita

doi:10.1111/j.1479-8077.2005.00115.x

Cited by 11 publications

(10 citation statements)

References 3 publications

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“…Dreyfuss found no significant difference between dexamethasone and triamcinolone in cervical TFESIs [20]. Anwar found no significant difference between triamcinolone and methylprednisolone in blind caudal ESIs [21]. Blankenbaker found no significant difference between betamethasone and triamcinolone in lumbar TFESIs [22].…”

Section: Discussionmentioning

confidence: 99%

“…As mentioned previously, studies evaluating volume and type of medication injected will continue to help shape best practice parameters. There is increasing literature [20‐23] addressing the type of corticosteroid used; however, more studies are needed. Additionally, studies comparing lidocaine, bupivacaine, and saline will also be important, as will studies comparing different volumes of injectate.…”

Section: Future Study Recommendationsmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of Lumbosacral Transforaminal Epidural Steroid Injections: A Systematic Review

Roberts¹,

Willick

Rho

et al. 2009

PM&R

121

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There is fair evidence supporting TFESIs as superior to placebo for treating radicular symptoms. There is good evidence that TFESIs should be used as a surgery-sparing intervention, and that TFESIs are superior to interlaminar ESIs (ILESIs) and caudal ESIs for radicular pain. In patients with subacute or chronic radicular symptoms, there is good evidence that a single TFESI has similar efficacy as a single transforaminal injection of bupivacaine or saline. Future studies should address the ideal number of injections. While more placebo-controlled trials are needed to conclusively define the role of TFESIs, current studies support their use in the treatment of lumbosacral radicular pain.

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Section: Discussionmentioning

confidence: 99%

Section: Future Study Recommendationsmentioning

confidence: 99%

Efficacy of Lumbosacral Transforaminal Epidural Steroid Injections: A Systematic Review

Roberts¹,

Willick

Rho

et al. 2009

PM&R

121

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“…Description of epidural/intradiscal injection studies Summary of interventions Sixty-three studies evaluated the use of epidural/intradiscal injection for sciatica 95, (eight studies had more than two treatment arms 146,149,161,163,167,169,183,197 181,[183][184][185]187,193,194,197,200,202 (two studies had more than two treatment arms 183,197 ) compared different modes of administering epidural/intradiscal injections and 20 studies 149,167,[177][178][179][180]182,186,[188][189][190][191][192]195,196,198,199,203,204,207 compared the use of different epidural/intradiscal injections. Details of the interventions are summarised in Table 17b, but the findings of these studies are not considered any further here.…”

Section: Epidural/intradiscal Injectionmentioning

confidence: 99%

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Lewis

Williams²,

Matar³

et al. 2011

Health Technol Assess

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAThe clinical effectiveness and costeffectiveness of management strategies for sciatica: systematic review and economic model NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA pro...

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“…Transforaminal epidural injections have been utilized for multiple indications including lumbar radiculitis with or without disc herniation, discogenic pain, spinal stenosis, and in post lumbar surgery syndrome (2)(3)(4)(5)7,11,(51)(52)(53). The comparative effectiveness of multiple types of steroids have also been studied (54)(55)(56). In addition, utilization of lumbar transforaminal epidural injections has increased 152% for the primary procedure and 218% for subsequent procedures as illustrated from 2002 to 2006 (1,7).…”

mentioning

confidence: 99%

Effectiveness of Therapeutic Lumbar Transforaminal Epidural Steroid Injections in Managing Lumbar Spinal Pain

Manchikanti

2012

Pain Phys

157

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Background: Among the multiple interventions used in managing chronic spinal pain, lumbar epidural injections have been used extensively to treat lumbar radicular pain. Among caudal, interlaminar, and transforaminal, transforaminal epidural injections have gained rapid and widespread acceptance for the treatment of lumbar and lower extremity pain. The potential advantages of transforaminal over interlaminar and caudal, include targeted delivery of a steroid to the site of pathology, presumably onto an inflamed nerve root. However, there are only a few well-designed, randomized, controlled studies on the effectiveness of steroid injections. Consequently, multiple systematic reviews with diverse opinions have been published. Study Design: A systematic review of therapeutic transforaminal epidural injection therapy for low back and lower extremity pain. Objective: To evaluate the effect of therapeutic transforaminal lumbar epidural steroid injections in managing low back and lower extremity pain. Methods: The available literature on lumbar transforaminal epidural injections in managing chronic low back and lower extremity pain was reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials and by the Newcastle-Ottawa Scale criteria for observational studies. Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to December 2011, and manual searches of the bibliographies of known primary and review articles. The level of evidence was classified as good, fair, or poor based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Outcome Measures: The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: For this systematic review, 70 studies were identified. Of these, 43 studies were excluded and a total of 27 studies met inclusion criteria for methodological quality assessment with 15 randomized trials (with 2 duplicate publications) and 10 non-randomized studies. For lumbar disc herniation, the evidence is good for transforaminal epidural with local anesthetic and steroids, whereas it was fair for local anesthetics alone and the ability of transforaminal epidural injections to prevent surgery. For spinal stenosis, the available evidence is fair for local anesthetic and steroids. The evidence for axial low back pain and post lumbar surgery syndrome is poor, inadequate, limited, or unavailable. Limitations: The limitations of this systematic review include the paucity of literature. Conclusion: In summary, the evidence is good for radiculitis secondary to disc herniation with local anesthetics and steroids and fair with local anesthetic only; it is fair for radiculitis secondary to spinal stenosis with local anesthetic and steroids; and limited for axial pain and post surgery syndrome using local anesthetic with or without steroids. Key words: Spinal pain, chronic low back pain, lower extremity pain, transforaminal epidural steroids, radiculopathy, sciatica, steroids, local anesthetic

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Prospective randomised single blind study of epidural steroid injection comparing triamcinalone acetonide with methylprednisolone acetate

Cited by 11 publications

References 3 publications

Efficacy of Lumbosacral Transforaminal Epidural Steroid Injections: A Systematic Review

Efficacy of Lumbosacral Transforaminal Epidural Steroid Injections: A Systematic Review

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Effectiveness of Therapeutic Lumbar Transforaminal Epidural Steroid Injections in Managing Lumbar Spinal Pain

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