Introduction: Acute lumbosacral radicular syndrome is often a medical disorder of difficult management. Epidural steroid injection is a useful approach for the herniated disc and radiculitis. The transforaminal approach is usually considered more effective and target-specific, but it can be associated with permanent lower extremity paralysis. A caudal approach with an adjustable catheter has been widely used in adhesiolysis in chronic low back pain, but there are no reports of its application in acute radicular pain. The aim of this study is to assess the clinical effectiveness of epidural steroid injection by caudal approach with an adjustable catheter in patients with severe acute radicular pain.
Methods: Fifty-five patients with severe acute radiculopathy were treated with epidural steroid injection by an epidural catheter whose tip can be directed laterally on the selected site. Numerical rating scale (NRS), pain relief, and analgesic consumption were observed after 1, 3, 6, and 12 months. Analgesic consumption (AC) and functional recovery (FR) have been considered secondary outcomes.
Results: We observed a significant reduction of NRS score that was constant every 12 months. Pain relief was good after 1 month and improved further after 3 months. Only a few patients perceived poor pain relief and only three patients relapsed. More than 70% of the patients were drug-free at the 12th month.
Conclusions: The caudal approach with adjustable catheter showed similar but more lasting effects on the acute severe radicular pain when compared to other epidural injections techniques; it is extremely target-specific and thus allows the use of small doses of corticosteroids; moreover, the adjustable catheter makes the procedure free from the risk of major complications.
Funding: No funding or sponsorship was received for this study. Sponsorship for article publication fees were funded by TSS Medical SRL.
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http://dx.doi.org/10.1007/s40122-018-0110-0 | DOI Listing |
Adv Healthc Mater
December 2024
Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK.
J Gastroenterol Hepatol
December 2024
Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China.
J Cardiovasc Electrophysiol
December 2024
Department of Cardiovascular Medicine, Institute of Science Tokyo, Tokyo, Japan.
JACC Clin Electrophysiol
November 2024
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Cureus
September 2024
Engineering, Skinister Medical, Woodland, USA.
Condom catheters are also called external urinary collection devices to collect urine and monitor urine output in hospitalized and other patients with urinary incontinence. They play an important role in reducing catheter-associated urinary tract infections by using invasive indwelling catheters that are placed inside the bladder. Currently, male external catheters come with or without adhesives.
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