Objective: Transforaminal epidural steroid injections (TESIs) are widely administered for sciatica. The aim of this trial was to evaluate the effectiveness of TESIs in patients with acute sciatica (<8 wk).
Methods: This study was conducted in 2 Dutch hospitals. Participants (n=141) were randomly assigned to (1) usual care and TESI of 1 ml of 40 mg/ml Methylprednisolone plus 1 ml of 0.5% Levobupivacaine (intervention 1); (2) usual care and transforaminal epidural injection with 1 ml of 0.5% Levobupivacaine and 1 ml NaCl 0.9% (intervention 2); (3) usual care consisting of oral pain medication with or without physiotherapy (control). Co-primary outcomes were back pain and leg pain intensity, physical functioning, and recovery measured during 6-month follow-up.
Results: There were no statistically significant mean differences in co-primary outcomes between groups during follow-up, except for leg pain when comparing intervention group 1 with control (-0.96 95%CI:-1.83 to -0.09). For secondary outcomes, some statistical significant between-group differences were found for treatment satisfaction and surgery, but only when comparing intervention group 2 to control. Post hoc analyses showed a statistically significant difference in response [50% improvement of leg pain (yes/no)] between intervention 1 and the control group at 3 months and that both intervention groups used less opioids.
Discussion: Except for a statistically significant effect of TESI on leg pain for patients with acute sciatica compared with usual care, there were no differences in co-primary outcomes. Nonetheless, transforaminal epidural injections seem to be associated with less opioid use, which warrants further exploration.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/AJP.0000000000001155 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effect of Caudal Epidural Steroid Injection on Transforaminal Epidural Steroid Injection and Dorsal Root Ganglion Pulsed Radiofrequency in Recurrent Lumbar Disc Herniation.
J Clin Med
December 2024
Pain Clinic, Mersin City Education and Research Hospital, Mersin 33343, Turkey.
Recurrent lumbar disc herniation (RLDH) refers to a lumbar disc herniation (LDH) that recurs at the same level, location, and side following surgical repair. This study aimed to evaluate the efficacy of transforaminal epidural steroid injection (TESI) and dorsal root ganglion pulsed radiofrequency (DRG PRF) therapy with and without caudal epidural steroid injection (CESI) for the treatment of lumbar radicular pain (LRP) associated with RLDH. This retrospective cohort study included 57 patients treated for RLDH in a hospital pain clinic between September 2022 and February 2024.
View Article and Find Full Text PDFInfluence of Obesity, Race and Gender on Radiation Exposure for Epidural Procedures.
Curr Pain Headache Rep
January 2025
Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Purpose Of Review: This retrospective, case controlled, comparative evaluation review of radiation exposure during epidural procedures in interventional pain management assessed variations in radiation exposure based on obesity, race, and gender.
Recent Findings: Numerous publications have shown increasing radiation exposure based on body mass index (BMI). However, the influence of race and gender have not been studied.
A Novel Approach of Ultrasound-Guided Transforaminal Cervical Nerve Root Injection With Fluoroscopic Validation: A Case Report and Technical Illustration.
Cureus
December 2024
Pain and Rehabilitation, Regen Clinic, Taipei, TWN.
Article Synopsis
- Cervical radiculopathies are typically treated with nerve root injections, and this study introduces a new ultrasound-guided technique for better visualization and injection accuracy.
- A 56-year-old patient with chronic C6 radiculopathy received treatment using this method, combining 5% dextrose and vitamin B12, which significantly improved their symptoms.
- The new technique ensures precise needle placement and effective medication spread while minimizing risks and reducing the need for fluoroscopy, lowering radiation exposure and enhancing treatment outcomes.
Dimensions of bony Kambin's triangle pertaining to endoscopic procedure.
Med J Armed Forces India
December 2024
Senior Consultant (Neurology), NH MMI Superspeciality, Raipur, Chhattisgarh, India.
Background: Endoscopic procedures nowadays are successful, minimally invasive, and safer, with fewer intraoperative and postoperative complications and shorter hospital stays. Kambin's triangle (KT) is the three-dimensional configuration that is used as a transforaminal anatomical corridor for epidural steroid injections and endoscopic surgeries for various lumbar pathologies. This study aims to estimate the dimensions of KT and diameter of the cannula for the transforaminal surgical approaches using KT in the Chhattisgarh population.
View Article and Find Full Text PDFComparison of patient radiation exposure and procedure time between CT-fluoroscopy and spiral CT for lumbar epidural steroid injections.
Skeletal Radiol
December 2024
Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02215, USA.
Objective: To compare patient radiation exposure and procedure time for lumbar epidural steroid injections (ESIs) performed under CT-fluoroscopy (CTF) vs spiral CT-guidance.
Materials And Methods: A retrospective cohort study of 767 consecutive lumbar ESIs performed between 2015-2023 using CTF vs spiral CT-guidance was conducted. Patient characteristics (age, sex, weight), procedural characteristics (injection level, type of ESI, trainee participation), and outcomes (patient radiation exposure, procedure time, pain relief, complications) were compared.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!