scholarly journals A prospective study on the role of epidural steroidal injections in backache with radiculopathy

2021 ◽  
Vol 8 (2) ◽  
pp. 125
Author(s):  
Akhil Gupta ◽  
Nitin Choudhary ◽  
Fareed Hussain Malik
Keyword(s):  
Conservative Treatment ◽  
Lumbar Disc ◽  
High Sensitivity ◽  
Well Being ◽  
Radicular Pain ◽  
Herniated Disc ◽  
Musculoskeletal Problem ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Sense Of Satisfaction

<p><strong>Background:</strong> Low backache (LBA) with lumbosacral radiculopathy is the most challenging musculoskeletal problem for its therapeutic management and cause of LBA with radiculopathy is a prolapsed disc. Epidural steroidal injection (ESI) are used in the management of the patients with sub-acute or chronic LBA with radiculopathy, not responding to conservative treatment. The most common cause being, lumbar disc disease, is confirmed via magnetic resonance imaging having high sensitivity and specificity.  The aim of study was to check the efficacy of ESI in patients of sub-acute or chronic low backache with radiculopathy due to herniated disc.</p><p><strong>Methods:</strong> The study was conducted over 200 patients reporting our OPD during Dec 2017- Feb 2018 with complaints of LBA with radiculopathy, not responding to conservative treatment. Maximum of 3 ESI were given with two weeks of interval in between. The patients were assessed using VAS scoring system.</p><p><strong>Results:</strong> 77.5% patients got improvement in symptoms, according to the VAS scores, while 22.5% patients got very little relief or no relief at all. 53.5% patients got significant improvement with the first dose of injection itself. Patients had a good relief from radicular pain immediately; however, sense of satisfaction of well-being was only after few months.</p><p><strong>Conclusions:</strong> Though results supported the relative benefit of epidural steroid, however conservative management should also be recommended as initial treatment. ESI procedure is effective in treating patients of sub-acute LBA with radiculopathy and is recommended before a patient is considered for surgery.</p>

Herniated lumbar disc disease in patients with malignancy.

1987 ◽  
Vol 5 (4) ◽  
pp. 667-671 ◽  
Author(s):  
R Goodkin ◽  
B I Carr ◽  
R G Perrin
Keyword(s):  
Spinal Metastasis ◽  
Lumbar Disc ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Herniated Disc ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Delay In Diagnosis ◽  
Patients With Cancer ◽  
Herniated Lumbar Disc

Six patients with cancer presented with signs and symptoms of a lumbar herniated disc syndrome due to a herniated lumbar disc. The differential diagnosis and literature are reviewed. In four of the six, the patients' complaints were attributed to the malignancy, with delay in diagnosis and institution of appropriate therapy. In two of the patients, treatment was administered for presumed spinal metastasis with radiation therapy and/or chemotherapy with castration before the correct diagnosis was made. Surgery was performed on all six patients confirming the diagnosis of a herniated lumbar disc at the involved level and relieving the patients' pain.

scholarly journals Does the Intradiscal Injection of Platelet Rich Plasma Have Any Beneficial Role in the Management of Lumbar Disc Disease?

2021 ◽  
pp. 219256822199836
Author(s):  
Sathish Muthu ◽  
Madhan Jeyaraman ◽  
Girinivasan Chellamuthu ◽  
Naveen Jeyaraman ◽  
Rashmi Jain ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
Platelet Rich Plasma ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Beneficial Role ◽  
Sf 36

Study Design: Systematic review and meta-analysis. Objectives: We performed this meta-analysis to evaluate whether intradiscal Platelet Rich Plasma(PRP) injection has any beneficial role in the management of lumbar disc disease. Methods: We conducted independent and duplicate electronic database searches including PubMed, Embase, and Cochrane Library till September 2020 for studies investigating the role of intradiscal PRP in the management of lumbar disc disease. The analysis was performed in the R platform using OpenMeta[Analyst] software. Results: 13 studies including 2 RCTs, 5 prospective, and 6 retrospective studies involving 319 patients were included in the meta-analysis. A single-arm meta-analysis of the included studies showed a beneficial effect of the intervention in terms of pain relief outcomes like VAS score (p < 0.001), pain component of SF-36 (p = 0.003) while such improvement was not seen in functional outcome measures like ODI score (p = 0.071), the physical component of SF-36 (p = 0.130) with significant heterogeneity noted among the included studies. No structural improvement in magnetic resonance imaging was observed (p = 0.106). No additional procedure-related adverse events were noted in the included studies (p = 0.662). Conclusion: There is a paucity of high-quality studies to give conclusive evidence on the benefits of intradiscal PRP for lumbar disc disease. Although intradiscal PRP injection has shown some beneficial effect in controlling pain for lumbar disc disease, we could not find structural or functional improvement from the included studies. Hence, we recommend large double-blind double-arm randomized controlled studies to analyze the benefits of the intervention being analyzed.

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