The Efficacy of Lumbar Epidural Steroid Injections in Patients with Lumbar Disc Herniations

Ackerman, William E.; Ahmad, Mahmud

doi:10.1213/01.ane.0000260307.16555.7f

Cited by 250 publications

(205 citation statements)

References 12 publications

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“…The contradictory results of the studies to date may be explained by numerous methodological faults and technical deficiencies [18,19,21,22]. Studies by Ackerman and Ahmad [23] and Schaufele et al [19] have proved that the TF approach is more efficient than the IL approach in the application of steroids. In our study, based on assessments of strongest and current pain during the previous 4 months, we cannot come to such a conclusion.…”

Section: Discussionmentioning

confidence: 99%

painDETECT Questionnaire and Lumbar Epidural Steroid Injection for Chronic Radiculopathy

Radoš

Zdravčević²,

Hrgović³

2012

Eur Neurol

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Background: The painDETECT questionnaire (PD-Q) is a fast and uncomplicated way to ascertain the percentage of neuropathic pain in ‘total pain’ and is designed to detect neuropathic pain components in back pain. The purpose of this randomized, prospective study is to compare, with the assessment of the PD-Q, the efficacy of interlaminar (IL) and transforaminal (TF) steroid injections in patients with unilateral chronic lumbar radicular pain. Methods: Patients were treated fluoroscopically with epidural steroids, using the IL or TF method and with confirmation of the epidural space by contrast, using random computerized classification. The patients received a series of three IL or TF epidural steroid injections (ESI) at 2-week intervals. The patients were monitored for 6 months from the first steroid injection. Results: By analyzing the average values of the total sum of points in the PD-Q a dropping trend is confirmed for both groups. The trend equation (y = –1.1393x + 25.269) for the TF ESI shows a faster recovery than the IL ESI (y = –0.8089x + 26.654). The statistically significant difference in the two groups is proved between the first and the sixth visit (IL ESI, p = 0.014; TF ESI, p = 0.001). There is no statistically significant difference in the efficiency of the two dosages and the volumes of steroids between the IL and TF distribution of steroids. Conclusions: Steroids are efficient; besides alleviating the overall pain, they also reduce the neuropathic component in chronic lumbar radicular pain, whether it is distributed epidurally by the IL or TF approach.

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Section: Discussionmentioning

confidence: 99%

painDETECT Questionnaire and Lumbar Epidural Steroid Injection for Chronic Radiculopathy

Radoš

Zdravčević²,

Hrgović³

2012

Eur Neurol

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“…Prior data has shown that transforaminal injections produce superior results compared to caudal or interlaminar approach [52]. In an effort to enhance the success of this treatment, recent literature has examined the role of patient position during epidural CSI injection.…”

Section: Treatment Non-operativementioning

confidence: 99%

Lumbar Disc Herniation

Amin

Andrade

Neuman³

2017

Curr Rev Musculoskelet Med

243

202

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Purpose of Review Substantial advancements have been made in the cause, diagnosis, imaging, and treatment options available for patients with lumbar disc herniation (LDH). We examined the current evidence and highlight the concepts on the frontline of discovery in LDH. Recent Findings There are a myriad of novel etiologies of LDH detailed in recent literature including inflammatory factors and infectious microbes. In the clinical setting, recent data focuses on improvements in computer tomography as a diagnostic tool and non-traditional injection options including tumor necrosis alpha inhibitors and platelet-rich plasma. Operative treatment outcomes have focused on minimally invasive endoscopic approaches and demonstrated robust 5-year post-operative outcomes. Summary Advances in the molecular etiology of LDH will continue to drive novel treatment options. The role of endoscopic treatment for LDH will continue to evolve. Further research into10-year outcomes will be necessary as this surgical approach continues to gain widespread popularity.

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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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The Efficacy of Lumbar Epidural Steroid Injections in Patients with Lumbar Disc Herniations

Abstract: The TF route of epidural steroid placement is more effective than the C or IL routes. We attribute this observation to a higher incidence of steroid placement in the ventral epidural space when the TF method is used.

Cited by 250 publications

References 12 publications

painDETECT Questionnaire and Lumbar Epidural Steroid Injection for Chronic Radiculopathy

painDETECT Questionnaire and Lumbar Epidural Steroid Injection for Chronic Radiculopathy

Lumbar Disc Herniation

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

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