Evaluation of Sagittal Spinopelvic Alignment on Analgesic Efficacy of Lumbar Epidural Steroid Injection in Geriatric Patients
<i>Background and Objectives</i>: The aim of this study was to evaluate the impact of sagittal imbalance based on pelvic incidence–lumbar lordosis (PI-LL) mismatch on the analgesic efficacy of epidural steroid injection in geriatric patients. <i>Materials and Methods</i>: Pat...
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MDPI AG
2022-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/10/1383 |
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| author | Hee Jung Kim Min Gi Ban Miribi Rho Woohyuk Jeon Shin Hyung Kim |
| author_facet | Hee Jung Kim Min Gi Ban Miribi Rho Woohyuk Jeon Shin Hyung Kim |
| author_sort | Hee Jung Kim |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: The aim of this study was to evaluate the impact of sagittal imbalance based on pelvic incidence–lumbar lordosis (PI-LL) mismatch on the analgesic efficacy of epidural steroid injection in geriatric patients. <i>Materials and Methods</i>: Patients aged 65 years or older who received lumbar epidural steroid injections under fluoroscopy were enrolled. The cutoff of PI-LL mismatch >20° was used as an indicator of a marked sagittal imbalance. The cross-sectional area of the psoas and paraspinal muscles, as well as the paraspinal fat infiltration grade were measured. A 50% or more decrease in pain score at four weeks after injection was considered as good analgesia. Variables were compared between PI-LL ≤ 20° and >20° groups and multivariate analysis was used to identify factors related to pain relief after injection. <i>Results</i>: A total of 237 patients consisting of 150 and 87 patients in the PI-LL ≤ 20° and >20° groups, respectively, were finally analyzed. Female patients, patients with lumbar surgery history, and the smaller cross-sectional area of the psoas muscles were predominantly observed in patients with sagittal imbalance. There was no difference in analgesic outcome after injection according to the PI-LL mismatch (good analgesia 60.0 vs. 60.9%, <i>p</i> = 0.889). Multivariate analysis showed that pre-injection opioid use, moderate to severe foraminal stenosis, and high-graded paraspinal fat infiltration were significantly associated with poor analgesia after injection. <i>Conclusions</i>: There was no significant correlation between sagittal spinopelvic alignment and pain relief after lumbar epidural steroid injection for geriatric patients. |
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| format | Article |
| id | doaj.art-e9936f79b0034d43b649a257d1ad7816 |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T19:51:42Z |
| publishDate | 2022-10-01 |
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| record_format | Article |
| series | Medicina |
| spelling | doaj.art-e9936f79b0034d43b649a257d1ad78162023-11-24T01:10:11ZengMDPI AGMedicina1010-660X1648-91442022-10-015810138310.3390/medicina58101383Evaluation of Sagittal Spinopelvic Alignment on Analgesic Efficacy of Lumbar Epidural Steroid Injection in Geriatric PatientsHee Jung Kim0Min Gi Ban1Miribi Rho2Woohyuk Jeon3Shin Hyung Kim4Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Anesthesiology and Pain Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, KoreaDepartment of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea<i>Background and Objectives</i>: The aim of this study was to evaluate the impact of sagittal imbalance based on pelvic incidence–lumbar lordosis (PI-LL) mismatch on the analgesic efficacy of epidural steroid injection in geriatric patients. <i>Materials and Methods</i>: Patients aged 65 years or older who received lumbar epidural steroid injections under fluoroscopy were enrolled. The cutoff of PI-LL mismatch >20° was used as an indicator of a marked sagittal imbalance. The cross-sectional area of the psoas and paraspinal muscles, as well as the paraspinal fat infiltration grade were measured. A 50% or more decrease in pain score at four weeks after injection was considered as good analgesia. Variables were compared between PI-LL ≤ 20° and >20° groups and multivariate analysis was used to identify factors related to pain relief after injection. <i>Results</i>: A total of 237 patients consisting of 150 and 87 patients in the PI-LL ≤ 20° and >20° groups, respectively, were finally analyzed. Female patients, patients with lumbar surgery history, and the smaller cross-sectional area of the psoas muscles were predominantly observed in patients with sagittal imbalance. There was no difference in analgesic outcome after injection according to the PI-LL mismatch (good analgesia 60.0 vs. 60.9%, <i>p</i> = 0.889). Multivariate analysis showed that pre-injection opioid use, moderate to severe foraminal stenosis, and high-graded paraspinal fat infiltration were significantly associated with poor analgesia after injection. <i>Conclusions</i>: There was no significant correlation between sagittal spinopelvic alignment and pain relief after lumbar epidural steroid injection for geriatric patients.https://www.mdpi.com/1648-9144/58/10/1383geriatric patientsepidural steroid injectionmuscle degenerationspinopelvic alignmentpain managementparaspinal muscles |
| spellingShingle | Hee Jung Kim Min Gi Ban Miribi Rho Woohyuk Jeon Shin Hyung Kim Evaluation of Sagittal Spinopelvic Alignment on Analgesic Efficacy of Lumbar Epidural Steroid Injection in Geriatric Patients Medicina geriatric patients epidural steroid injection muscle degeneration spinopelvic alignment pain management paraspinal muscles |
| title | Evaluation of Sagittal Spinopelvic Alignment on Analgesic Efficacy of Lumbar Epidural Steroid Injection in Geriatric Patients |
| title_full | Evaluation of Sagittal Spinopelvic Alignment on Analgesic Efficacy of Lumbar Epidural Steroid Injection in Geriatric Patients |
| title_fullStr | Evaluation of Sagittal Spinopelvic Alignment on Analgesic Efficacy of Lumbar Epidural Steroid Injection in Geriatric Patients |
| title_full_unstemmed | Evaluation of Sagittal Spinopelvic Alignment on Analgesic Efficacy of Lumbar Epidural Steroid Injection in Geriatric Patients |
| title_short | Evaluation of Sagittal Spinopelvic Alignment on Analgesic Efficacy of Lumbar Epidural Steroid Injection in Geriatric Patients |
| title_sort | evaluation of sagittal spinopelvic alignment on analgesic efficacy of lumbar epidural steroid injection in geriatric patients |
| topic | geriatric patients epidural steroid injection muscle degeneration spinopelvic alignment pain management paraspinal muscles |
| url | https://www.mdpi.com/1648-9144/58/10/1383 |
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