EPIDURAL STEROID INJECTION IN HERNIATED DISC AND LUMBAR CANAL STENOSIS: IS IT JUST A PLACEBO?
ABSTRACT Objective To study the role of epidural steroid injection (ESI) in patients with lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). ESIs are regularly used to support non-operative treatment for LBP, and our anecdotal impression is that a considerable proportion of patients rep...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Coluna (SBC)
2021-09-01
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| Series: | Coluna/Columna |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512021000300189&tlng=en |
| _version_ | 1818891773331636224 |
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| author | AJAY KUMAR SHETTY PAPANNA SUJITH RAO VITTALDAS BALAMURUGAN THIRUGNANAM VIDYADHARA SRINIVASA |
| author_facet | AJAY KUMAR SHETTY PAPANNA SUJITH RAO VITTALDAS BALAMURUGAN THIRUGNANAM VIDYADHARA SRINIVASA |
| author_sort | AJAY KUMAR SHETTY PAPANNA |
| collection | DOAJ |
| description | ABSTRACT Objective To study the role of epidural steroid injection (ESI) in patients with lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). ESIs are regularly used to support non-operative treatment for LBP, and our anecdotal impression is that a considerable proportion of patients report substantial pain relief after ESI. Methods One thousand consecutive patients (645 patients with LDH and 355 patients with LCS) who required ESI from January-August 2018 were included. All were given the same ESI, prepared with triamcinolone (80 mg), bupivacaine (0.25%, 4 ml) and normal saline (4 ml). Patients were evaluated using the numerical rating scale (NRS) immediately after the injection, after 7 days, and after 3 months. Results The mean NRS back-pain score of the LDH-group was reduced from 5 (range: 4-8) to 4 (range: 2-7) immediately after injection, 2 (range: 1-7) after 7 days and 2 (range: 1-7) after 3 months (p-value<0.001). The mean NRS back-pain score of the LCS-group was reduced from 5 (range: 4-8) to 4 (range: 2-7) immediately after injection, 2 (range: 1-7) after 7 days and 3 (range: 1-7) after 3 months (p-value <0.001). The mean NRS leg-pain score of the LDH group was reduced from 5 (range: 4-9) to 3 (range: 3-7) immediately after injection, 1 (range: 1-6) after 7 days and 2 (range: 1-7) after 3 months (p-value <0.001). The mean NRS leg-pain score of the LCS group was reduced from 5 (range: 4-9) to 4 (range: 3-7) immediately after injection, 3 (range: 1-7) after 7 days and 2 (range 1-6) after 3 months (p-value <0.001). Conclusion ESI causes statistically significant improvement in back and leg pain in patients with LDH and LCS. However, the short and medium-term efficacy of ESI in the LCS group was lower than in the LDH group. Level of evidence IV; Prospective hospital-based study. |
| first_indexed | 2024-12-19T17:46:08Z |
| format | Article |
| id | doaj.art-7a0fc46178824fe6b0644d270c7704cd |
| institution | Directory Open Access Journal |
| issn | 2177-014X |
| language | English |
| last_indexed | 2024-12-19T17:46:08Z |
| publishDate | 2021-09-01 |
| publisher | Sociedade Brasileira de Coluna (SBC) |
| record_format | Article |
| series | Coluna/Columna |
| spelling | doaj.art-7a0fc46178824fe6b0644d270c7704cd2022-12-21T20:12:04ZengSociedade Brasileira de Coluna (SBC)Coluna/Columna2177-014X2021-09-0120318919110.1590/s1808-185120212003241111EPIDURAL STEROID INJECTION IN HERNIATED DISC AND LUMBAR CANAL STENOSIS: IS IT JUST A PLACEBO?AJAY KUMAR SHETTY PAPANNAhttps://orcid.org/0000-0001-5611-6940SUJITH RAO VITTALDAShttps://orcid.org/0000-0002-0076-8816BALAMURUGAN THIRUGNANAMhttps://orcid.org/0000-0001-8610-4414VIDYADHARA SRINIVASAhttps://orcid.org/0000-0002-3135-7681ABSTRACT Objective To study the role of epidural steroid injection (ESI) in patients with lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). ESIs are regularly used to support non-operative treatment for LBP, and our anecdotal impression is that a considerable proportion of patients report substantial pain relief after ESI. Methods One thousand consecutive patients (645 patients with LDH and 355 patients with LCS) who required ESI from January-August 2018 were included. All were given the same ESI, prepared with triamcinolone (80 mg), bupivacaine (0.25%, 4 ml) and normal saline (4 ml). Patients were evaluated using the numerical rating scale (NRS) immediately after the injection, after 7 days, and after 3 months. Results The mean NRS back-pain score of the LDH-group was reduced from 5 (range: 4-8) to 4 (range: 2-7) immediately after injection, 2 (range: 1-7) after 7 days and 2 (range: 1-7) after 3 months (p-value<0.001). The mean NRS back-pain score of the LCS-group was reduced from 5 (range: 4-8) to 4 (range: 2-7) immediately after injection, 2 (range: 1-7) after 7 days and 3 (range: 1-7) after 3 months (p-value <0.001). The mean NRS leg-pain score of the LDH group was reduced from 5 (range: 4-9) to 3 (range: 3-7) immediately after injection, 1 (range: 1-6) after 7 days and 2 (range: 1-7) after 3 months (p-value <0.001). The mean NRS leg-pain score of the LCS group was reduced from 5 (range: 4-9) to 4 (range: 3-7) immediately after injection, 3 (range: 1-7) after 7 days and 2 (range 1-6) after 3 months (p-value <0.001). Conclusion ESI causes statistically significant improvement in back and leg pain in patients with LDH and LCS. However, the short and medium-term efficacy of ESI in the LCS group was lower than in the LDH group. Level of evidence IV; Prospective hospital-based study.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512021000300189&tlng=enBack PainHerniaSpinal Stenosis |
| spellingShingle | AJAY KUMAR SHETTY PAPANNA SUJITH RAO VITTALDAS BALAMURUGAN THIRUGNANAM VIDYADHARA SRINIVASA EPIDURAL STEROID INJECTION IN HERNIATED DISC AND LUMBAR CANAL STENOSIS: IS IT JUST A PLACEBO? Coluna/Columna Back Pain Hernia Spinal Stenosis |
| title | EPIDURAL STEROID INJECTION IN HERNIATED DISC AND LUMBAR CANAL STENOSIS: IS IT JUST A PLACEBO? |
| title_full | EPIDURAL STEROID INJECTION IN HERNIATED DISC AND LUMBAR CANAL STENOSIS: IS IT JUST A PLACEBO? |
| title_fullStr | EPIDURAL STEROID INJECTION IN HERNIATED DISC AND LUMBAR CANAL STENOSIS: IS IT JUST A PLACEBO? |
| title_full_unstemmed | EPIDURAL STEROID INJECTION IN HERNIATED DISC AND LUMBAR CANAL STENOSIS: IS IT JUST A PLACEBO? |
| title_short | EPIDURAL STEROID INJECTION IN HERNIATED DISC AND LUMBAR CANAL STENOSIS: IS IT JUST A PLACEBO? |
| title_sort | epidural steroid injection in herniated disc and lumbar canal stenosis is it just a placebo |
| topic | Back Pain Hernia Spinal Stenosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512021000300189&tlng=en |
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