Background: Lumbar epidural injections have been studied as symptomatic treatments for lumbar spinal stenosis (LSS). However, results about their efficacy have been controversial, and data regarding their use is scarce. Our purpose in this article is to study the efficacy of epidural injections in the management of pain and disability in patients suffering from spinal stenosis, to study the factors which can affect their efficacy, and to discuss whether they could replace surgery or not.
Methods: A retrospective study between 2021 and 2022 took place in a Pain Clinic located in Notre-Dame des Secours University Hospital-Lebanon. The study was done on 128 patients, of whom 18 were excluded because they underwent laminectomy before taking the transforaminal lumbar epidural injections. Medical records were viewed. Outcome measures were checked before and after epidural injections using the numerical pain scale and the Oswestry Disability Index (ODI) scale. Physical activity was assessed with a physical activity index.
Results: Back pain scores (9.46 ± 1.07 vs. 3.91 ± 3.13; P < 0.001), leg pain scores (9.31 ± 1.41 vs. 3.75 ± 3.17; P < 0.001), and ODI scores (27.45 ± 8.97 vs. 9.40 ± 9.42; P < 0.001) decreased after the injection compared to before it. A higher physical activity index was significantly associated with a decrease in back pain, leg pain, and ODI scores after epidural injection. In 57.8% of the patients, epidural injections were sufficient for pain management without the need for surgery.
Conclusion: Epidural injections are effective in the management of back and leg pain associated with LSS and in improving patients' disability. Engaging in activities like walking and swimming is associated with better results. In some cases, epidural injections may replace surgery.
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http://dx.doi.org/10.6859/aja.202403_62(1).0005 | DOI Listing |
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.
Asian J Anesthesiol
December 2024
School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.
Background: Lumbar epidural injections have been studied as symptomatic treatments for lumbar spinal stenosis (LSS). However, results about their efficacy have been controversial, and data regarding their use is scarce. Our purpose in this article is to study the efficacy of epidural injections in the management of pain and disability in patients suffering from spinal stenosis, to study the factors which can affect their efficacy, and to discuss whether they could replace surgery or not.
View Article and Find Full Text PDFSpine J
December 2024
Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA. Electronic address:
Background Context: Cervical epidural steroid injections (CESIs) are commonly used in management of cervical pathology. While severe complications have been reported, they are rare, and thus their incidence and risk factors have not been well characterized.
Purpose: To determine the incidence of complications 7, 30, and 90 days after CESI and to identify associated risk factors.
Pain Physician
December 2024
Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Background: The analysis of epidural procedure utilization has revealed several notable trends over recent years. Utilization increased significantly until 2004, then rose minimally until 2011, followed by gradual declines up to 2019 in the Medicare population. The COVID-19 pandemic led to a marked 19% decline in usage from 2019 to 2020.
View Article and Find Full Text PDFAm J Phys Med Rehabil
December 2024
From the Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey (GY, CST); and Division of Pain Medicine, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey (SS, OHG).
Objective: Trigger point-related myofascial pain commonly accompanies cervical disc herniation. The aim of the study is to investigate the effect of dry needling for accompanying trigger points on cervical interlaminar epidural steroid injection treatment outcomes.
Design: Among the patients scheduled for interlaminar epidural steroid injection for cervical disc herniation, those with active trigger points were randomly divided into three groups: interlaminar epidural steroid injection + dry needling, interlaminar epidural steroid injection + sham dry needling, and only interlaminar epidural steroid injection group.
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