Fluoroscopic Epidural Steroid Injection: Pain Relief in Discogenic Sciatica Versus Lumbar Spinal Stenosis. A Study on Middle Eastern Patients.

Q3 Medicine

Acta medica (Hradec Kralove) Pub Date : 2020-01-01 DOI:10.14712/18059694.2020.20

Todor Shamov, Jasem Y Al-Hashel, Rossen T Rоusseff

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引用次数: 3

Abstract

Objective: To compare the effect of epidural steroid injections (ESI) in patients with discogenic sciatica (Sci) versus patients with lumbar canal stenosis (LSS), not controlled by conservative treatment.

Materials and methods: In our study, 80 patients with Sci and 66 with LSS were included. A single ESI (10 mg dexamethasone in 3 cc 0.25% bupivacaine) was applied under fluoroscopic control: one level above the highest stenotic level, in the posterior epidural space, via interlaminar approach in LSS and at the prolapse level, in the anterior epidural space, via transforaminal route in Sci. Pain intensity was assessed by VAS at baseline and on days 1, 15 and 30 after intervention.

Results: The procedure was successful in 78 Sci and 63 LSS patients. Patients with Sci responded significantly better. At one month, pain reduction over 50% was achieved in 63% (52.3-73.7% at p = 0.95) of Sci but only in 35% (23.2-46.8%) of LSS (p = 0.03). Return to pre-intervention level happened in 47% (34.7-59.3%) of LSS versus 14% (6.3-21.7%) of Sci patients (p = 0.01). In 5 patients the procedure failed, without resulting morbidity.

Conclusion: ESI are more effective in patients with Sci than in single level LSS. In multiple level LSS, results are disappointing.

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透视硬膜外类固醇注射:减轻椎间盘源性坐骨神经痛与腰椎管狭窄症的疼痛。中东病人的研究。

目的:比较硬膜外类固醇注射(ESI)治疗椎间盘源性坐骨神经痛(Sci)与未接受保守治疗的腰椎管狭窄(LSS)患者的疗效。材料与方法:本研究纳入Sci患者80例，LSS患者66例。在透视控制下使用单次ESI(地塞米松10 mg加入3毫升0.25%布比卡因中):在最高狭窄水平之上一个水平，在LSS中通过层间入路，在脱垂水平，在前硬膜外空间，在Sci中通过椎间孔入路。在基线及干预后第1、15、30天采用VAS评估疼痛强度。结果:78例Sci患者和63例LSS患者手术成功。脊髓损伤患者的反应明显更好。1个月时，63% (52.3-73.7%，p = 0.95)的Sci患者疼痛减轻超过50%，而只有35% (23.2-46.8%，p = 0.03)的LSS患者疼痛减轻超过50%。47%(34.7 ~ 59.3%)的LSS患者恢复到干预前水平，而14%(6.3 ~ 21.7%)的Sci患者恢复到干预前水平(p = 0.01)。5例手术失败，无并发症。结论:ESI对脊髓损伤患者的治疗效果优于单级LSS。在多级LSS中，结果令人失望。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta medica (Hradec Kralove) Medicine-Medicine (all)

CiteScore

1.10

自引率

0.00%

发文量

审稿时长

20 weeks

期刊介绍： Acta Medica (Hradec Králové) is a multidisciplinary medical journal published by the Faculty of Medicine in Hradec Králové - Karolinum Press, the publishing house of Charles University. The journal is peer-reviewed and published quarterly in both paper and electronic form. The language of Acta Medica is English. Offerings include review articles, original articles, brief communications, case reports, announcements and notices. The journal was founded in 1958 under the title "A Collection of Scientific Works of the Charles University Faculty of Medicine in Hradec Kralove."