The use of epidural steroids for sciatica

Rooers, P.; Schiller, Dietmar; Nash, Todd

doi:10.1016/0304-3959(87)91256-5

Cited by 22 publications

(45 citation statements)

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“…However, a number of authors have demonstrated the superiority of steroids over other substances. Thus, Rogers et al [ 11] examined 30 patients with lumbar root irritation in a prospective, randomized single-blind study. A significantly better result was achieved by lumbar epidural injection of steroids and local anaesthetics than by injection of local anaesthetics alone.…”

Section: Discussionmentioning

confidence: 98%

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Periradicular therapy in lumbar radicular syndromes: Methodology and results

et al. 1997

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Periradicular therapy (PRT) has become popular in the treatment of lumbar radicular complaints, both primary, due to disc herniations (Group 1), and postoperative, following disc surgery (Group 2). However, hitherto reported data on 'periradicular injections' are more of a technical nature. The present study was designed to evaluate the therapeutic success of CT- versus fluoroscope-guided periradicular injections of local anaesthetics and corticoids, and to investigate the impact of imaging procedures on the results. We report on 80 patients who underwent CT-guided (n = 40) or fluoroscope-guided (n = 40) PRT for lumbar radicular irritation since April 1993. Forty patients had primary nerve root irritation due to disc protrusion, and 40 suffered from postoperative epidural fibrosis. Follow-up consisted in a clinical examination and an interview one day after each injection as well as 1 and 6 months later. Assessment was based on a score taking into account the clinical findings, the patient's complaints, and the patient's evaluation. Six months following treatment there was a significant reduction of ischialgia in both Groups 1 and 2 (p < 0.001). However, the results were significantly poorer in Group 2 (postoperative). Among the patients not operated on, those who underwent CT-guided injections had a significantly better outcome (p < 0.001). PRT had no significant influence on low back pain or pseudoradicular syndromes. The improvement of sensory disturbances achieved by both CT- and fluoroscope-guided injections in patients not previously submitted to surgery is statistically significant (p < 0.05). As compared to Group 1 (no surgery), the positive effects in patients of Group 2 were of significantly shorter duration (p < 0.05). Motor deficits were not influenced by the treatment. Long-term follow-up shows that there is no positive effect in those patients in whom the first two PRT attempts had failed. Thus, PRT represents a useful long-term therapeutic alternative for lumbar radicular syndromes, particularly when due to primary discogenic compression. CT-guided injection is superior to fluoroscope-assisted treatment for both its visualization and its longer-lasting effect.

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Section: Discussionmentioning

confidence: 98%

“…Irrespective of the method, nearly all patients reported a sensation identical with their spontaneous pain [11] following proper placement of the needle tip. We designate this as "memory pain".…”

Section: Techniquementioning

confidence: 88%

Periradicular therapy in lumbar radicular syndromes: Methodology and results

et al. 1997

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“…The Cochrane review included six pragmatic trials that reported on short-term pain relief [8,22,38,63,77,78]. Four of these six trials showed a non-significant positive effect of corticosteroids compared to other procedures.…”

Section: Epidural Injections Vs Other Interventionsmentioning

confidence: 99%

Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

et al. 2005

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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 use of epidural steroids for sciatica

Cited by 22 publications

References 0 publications

Periradicular therapy in lumbar radicular syndromes: Methodology and results

Periradicular therapy in lumbar radicular syndromes: Methodology and results

Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

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

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