Background: Epidural steroid injections (ESI) are the most common pain management procedure performed in the US, however evidence of efficacy is limited. In addition, there is early evidence that the high dose of corticosteroids used can have systemic side effects. We describe the results of a case series evaluating the use of platelet lysate (PL) epidural injections for the treatment of lumbar radicular pain as an alternative to corticosteroids.
Methods: Registry data was obtained for patients (N = 470) treated with PL epidural injections presenting with symptoms of lumbar radicular pain and MRI findings that were consistent with symptoms. Collected outcomes included numeric pain score (NPS), functional rating index (FRI), and a modified single assessment numeric evaluation (SANE) rating.
Results: Patients treated with PL epidurals reported significantly lower (p < .0001) NPS and FRI change scores at all time points compared to baseline. Post-treatment FRI change score means exceeded the minimal clinically important difference beyond 1 month. Average modified SANE ratings showed 49.7% improvement at 24 months post-treatment. Twenty-nine (6.3%) patients reported mild adverse events related to treatment.
Conclusion: Patients treated with PL epidurals reported significant improvements in pain, exceeded the minimal clinically important difference (MCID) for FRI, and reported subjective improvement through 2-year follow-up. PL may be a promising substitute for corticosteroid.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701904 | PMC |
http://dx.doi.org/10.1186/s40634-017-0113-5 | DOI Listing |
Sci Rep
January 2025
Department of Neurosurgery, Seoul National University Hospital, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Lumbar foraminal stenosis can be surgically treated by foraminal decompression or facet joint resection and fusion (transforaminal lumbar interbody fusion, TLIF). While conventional foraminal decompression poses a risk of segmental instability, the endoscopic approach (extended endoscopic lumbar foraminotomy, EELF) resects only the ventral part of the facet joint with a horizontal surgical trajectory. A prospective observational study was performed to analyze the cost-effectiveness of EELF versus TLIF.
View Article and Find Full Text PDFPain Pract
February 2025
North American Spine & Pain, 404 Creek Crossing Blvd, Hainesport, 08056, New Jersey, USA.
Radiofrequency ablation (RFA) is an interventional procedure that has been used to treat chronic back pain for over 50 years; this unique case report demonstrates the effectiveness of pulsed radiofrequency ablation (PRFA) on the dorsal root ganglion (DRG) in the treatment of chronic radicular pain (Russo et al., 2021, J Pain Res, 14, 3897). The RFA provides pain relief by using thermal energy to disrupt peripheral nerves carrying nociceptive signals back to the central nervous system (Abd-Elsayed et al.
View Article and Find Full Text PDFJ Neurosurg Spine
January 2025
2Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland; and.
Objective: Spinal fusion is a commonly performed surgical procedure used to relieve pain, deformity, and instability of various spinal pathologies. Although there have been attempts to standardize spinal fusion assessment radiologically, there is currently no unified definition that also considers clinical symptomology. This review attempts to create a more holistic and standardized definition of spinal fusion.
View Article and Find Full Text PDFJ Surg Case Rep
January 2025
Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), 1000 rue St-Denis, Montreal, QC H2X 0C1, Canada.
Intervertebral thoracic disk herniation (TDH) is a rare occurrence and presents with a wide variety of symptoms. Errors in diagnosis are thought to be frequent due to the variable clinical presentations. We herein present two unusual cases of TDH presenting with abdominal pseudohernias, abdominal pain, and hypoesthesia along the T11-T12 dermatomes due to TDH at the same level.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
University of Tunis El Manar, Faculty of Medicine of Tunis, 1007, Tunisia; Department of Orthopedic Surgery, Hospital Mongi Slim La Marsa, Tunisia.
Introduction And Importance: Osteoblastoma is a rare benign bone tumor, accounting for 1 % of primary bone tumors, often affecting the spine and sacrum. Accurate diagnosis is essential for appropriate treatment and prognosis.
Case Presentation: A 19-year-old male presented with two years of persistent nocturnal radicular and low back pain unresponsive to anti-inflammatory medications.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!