Evaluation of Treatment of Herniated Lumbar Disc Sciatica by Epidural Corticosteroid Injection

Quang-Tri Lê, Minh-Hoang Nguyen
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Abstract

Background: Medical facilities in Vietnam both use Methylprednisolone acetate and Hydrocortisone acetate in treatment with different administrations. This study aimed to evaluate of effects and side-effects of epidural injection of Methylprednisolone acetate and Hydrocortisone acetate in the treatment of herniated lumbar disc sciatica. Methods and findings: Cross-sectional descriptive study on 80 herniated lumbar disc sciatica patients treated at Department of Orthopedic, 7A Military Hospital, Hochiminh City, VietNam. The patients were divided into two groups in coupling fashion based on the VAS score of pain. Study results showed that both corticosteroid drugs (Methylprednisolone acetate and Hydrocortisone acetate) yielded good outcomes on all investigated parameters and there was no significant difference between the two medications (p < 0.05); administration of Methylprednisolone acetate reduced VAS score of 1.98 ± 1.33 points and Hydrocortisone acetate reduced of 2.13 ± 1.17 points. Lasegue test score in Methylprednisolone acetate administered patients raised from 74.630 ± 18.820 to 80.750 ± 15.870 and in Hydrocortisone acetate patients from 71.250 ± 10.110 to 81.630 ± 8.350). Treatment methods were safe, and there was no difference in complication rates between the two groups. The direct and indirect cost of Hydrocortisone acetate administration was three times higher than Methylprednisolone acetate. Conclusion: It was safe and effective to administrate both Methylprednisolone acetate and Hydrocortisone acetate in the treatment of herniated lumbar disc sciatica. Methylprednisolone acetate administration was more economical than Hydrocortisone acetate. Keywords: Sciatica, epidural injection, Methylprednisolone acetate, Hydrocortisone acetate
硬膜外注射皮质类固醇治疗坐骨神经痛腰椎间盘突出症的疗效评价
背景:越南的医疗机构都使用醋酸甲基强的松和醋酸氢化可的松以不同的剂量进行治疗。本研究旨在评价硬膜外注射醋酸甲基强的松和醋酸氢化可的松治疗腰椎间盘突出性坐骨神经痛的疗效和副作用。方法与结果:对越南胡志明市7A军医院骨科收治的80例腰椎间盘突出性坐骨神经痛患者进行横断面描述性研究。根据疼痛VAS评分将患者分为两组。研究结果显示,两种皮质类固醇药物(醋酸甲基强的松和醋酸氢化可的松)在所有研究参数上均获得良好的结局,两种药物之间无显著性差异(p < 0.05);醋酸甲泼尼龙组VAS评分分别为1.98±1.33分和2.13±1.17分。醋酸甲泼尼龙组Lasegue评分由74.630±18.820上升至80.750±15.870,醋酸氢化可的松组由71.250±10.110上升至81.630±8.350。治疗方法安全,两组并发症发生率无差异。使用醋酸氢化可的松的直接和间接费用是使用醋酸甲基强的松龙的3倍。结论:醋酸甲泼尼龙联合醋酸氢化可的松治疗腰椎间盘突出症坐骨神经痛安全有效。使用醋酸甲泼尼龙比使用醋酸氢化可的松更经济。关键词:坐骨神经痛,硬膜外注射,醋酸甲泼尼龙,醋酸氢化可的松
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