scholarly journals Clinical effectiveness of selective nerve root block in lumbar radiculopathy

2021 ◽  
Author(s):  
Atul Singh ◽  
Tanmay Mallick ◽  
Sarvesh Kumar Singh ◽  
Ajay Abrol
Keyword(s):  
Steroid Injection ◽  
Lumbar Disc ◽  
Epidural Steroid Injection ◽  
Functional Improvement ◽  
Post Injection ◽  
Success Rates ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid

<p class="abstract"><strong>Background:</strong> Epidural steroid injections (ESIs) have been used as an adjunct in the treatment of sciatica. Since the early reports, success rates ranging from 18% to 90% (average, 67%) have been documented. However, the efficacy of ESI has lasted, on the average, less than 3 months.</p><p class="abstract"><strong>Methods:</strong> This study was conducted at Abrol medical centre, Punjab from June 2019 to June 2020. One hundred patients with back pain documented with lumbar disc disease treated initially with rest, analgesics and physiotherapy for at least six weeks were included in the study and treated with transforaminal epidural steroid injection. The protocol of the study was approved by ethical committee. Patients to be participated in this study were documented. Patients with lumbar disc disease were given transforaminal epidural steroid injection in Orthopaedics operation theatre of our institute. Informed and written consent were obtained as per ethical committee guidelines.<strong></strong></p><p class="abstract"><strong>Results:</strong> Pre-procedure Roland Morris disability mean score was 17.54 and it got reduced to 5.57 by 4<sup>th</sup> day immediately post injection, was 6.44 by 6 weeks, by 3<sup>rd</sup> month 7.1 and by end of 6 months it was 8.34. Improvement in score on 4<sup>th</sup> day post injection was 68.24 percent which is considered significant and successful.</p><p class="abstract"><strong>Conclusions:</strong> Transforaminal epidural steroid treatment better medication for pain relief, patient satisfaction, disability improvement and functional improvement.</p>

scholarly journals Efficacy of epidural steroid injection in lumbar disc disease

2018 ◽  
Vol 4 (3.1) ◽  
pp. 01-05
Author(s):  
Dr. Vivian D Almeida ◽  
Dr. Vinayak ◽  
Dr. Ashwin Kamath ◽  
Dr. Jubin Abraham Raju ◽  
Dr. K Raghuveer Adiga
Keyword(s):  
Steroid Injection ◽  
Lumbar Disc ◽  
Epidural Steroid Injection ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Epidural Steroid

scholarly journals Caudal epidural steroid injection ultrasound-guided versus fluoroscopy-guided in treatment of refractory lumbar disc prolapse with radiculopathy

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed Ahmed Elashmawy ◽  
Reham M. Shaat ◽  
A. M. Abdelkhalek ◽  
Ebrahim El Boghdady
Keyword(s):  
Steroid Injection ◽  
Lumbar Disc ◽  
Epidural Steroid Injection ◽  
Successful Outcome ◽  
Post Injection ◽  
Disc Prolapse ◽  
Lumbar Disc Prolapse ◽  
Straight Leg Raising ◽  
Epidural Steroid ◽  
Caudal Epidural

Abstract Background Lumbar disc prolapse is a localized herniation of disc beyond intervertebral disc space and is the most common cause of sciatica; the aim of this study is to investigate the efficacy of ultrasound (US)-guided caudal epidural steroid injection (CESI) compared with fluoroscopy (FL)-guided CESI in treatment of patients with refractory lumbar disc prolapse (LDP) with radiculopathy. Results At the beginning of the study, there was no significant difference between both groups in all parameters. (a) Group 1 had significantly improved the straight leg raising and modified Schober tests, VAS, and ODI at 1-month and 3-month post-injection evaluation in comparison to baseline recordings (p < 0.001); (b) Group 2 had significantly improved the straight leg raising and modified Schober tests, VAS, and ODI at 1-month and 3-month post-injection evaluation in comparison to baseline recordings (p < 0.001); and (c) US-guided CESI was not statistically different from the FL-guided CESI in the improvement of the straight leg raising (p = 0.87, 0.82) and modified Schober tests (p = 0.87, 0.82) as well as VAS (p = 0.40, 0.43) and ODI (p = 0.7, 0.2) at 1-month and 3-month post-injection evaluation. In a multivariate analysis using CI = 95%, the significant predictors for a successful outcome were duration < 6 months (p = 0.03, OR = 2.25), target level not L2-3/L3-4 (p < 0.001, OR = 4.13), and LDP other than foraminal type (p = 0.002, OR = 3.78). However, age < 40 years was found to be non-significant in predicting a successful outcome (p = 0.38, OR = 0.98). Conclusion US is excellent in guiding CESI with similar treatment outcomes as compared with FL-guided CESI. Trial registration ClinicalTrials.gov Identifier: NCT03933150.

scholarly journals Transforaminal Epidural Steroid Injection Combined with Radio Frequency for the Treatment of Lumbar Disc Herniation: A 2-year Follow-up

2020 ◽  
Author(s):  
Wenbo Wei ◽  
Shajie Dang ◽  
Ling Wei ◽  
Tian Liu ◽  
Jue Wang
Keyword(s):  
Radio Frequency ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Epidural Steroid Injection ◽  
Hospitalization Time ◽  
Post Operation ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid

Abstract Objective: To assess the therapeutic efficacy of transforaminal epidural steroid injection (TFESI) combined with radio frequency (RF) for the treatment of lumbar disc herniation (LDH). Methods: A total of 230 patients participated in the study: TFESI (Group T, n=110), TFESI combined with RF (Group TR, n=120). Visual analogue scale (VAS), Oswestry disability index (ODI) and Global perceived effect (GPE) scale were measured pre-operation, 1, 3, 6, 12 and 24 months after the operation. Hospitalization time, operation time, complications, and recurrence were compared between the two groups.Results: The VAS and ODI at each observation point of the post-operation were significantly decreased compared with the pre-operation in both groups (P < 0.05). There was no statistically different of VAS and ODI between the two groups at 1 and 3 months of the post-operation (P > 0.05). However, The VAS and ODI scores in Group TR were significantly lower than that in Group T at 6, 12 and 24 months of the post-operation (P < 0.05). The GPE in group TR was high in the early days, while that at 1 and 3 month after treatment was significantly higher than that in group T (P < 0.05). The recurrence rate in Group TR was lower than that in Group T (P = 0.002). There was no significant difference of hospitalization time, complications, VAS and ODI score at the pre-operation between the two groups (P > 0.05).Conclusion: These findings suggest that TFESI combined with RF could effectively improve the pain and function, and had a long-term satisfactory effect for the treatment of LDH.

scholarly journals Transforaminal epidural steroid injection combined with radio frequency for the treatment of lumbar disc herniation: a 2-year follow-up

2021 ◽  
Author(s):  
Wenbo Wei ◽  
Shajie Dang ◽  
Ling Wei ◽  
Tian Liu ◽  
Jue Wang
Keyword(s):  
Radio Frequency ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Epidural Steroid Injection ◽  
Hospitalization Time ◽  
Post Operation ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid

Abstract Objective: To assess the therapeutic efficacy of transforaminal epidural steroid injection (TFESI) combined with radio frequency (RF) for the treatment of lumbar disc herniation (LDH). Methods: A total of 230 patients participated in the study: TFESI (Group T, n=110), TFESI combined with RF (Group TR, n=120). Visual analogue scale (VAS), Oswestry disability index (ODI) and Global perceived effect (GPE) scale were measured pre-operation, 1, 3, 6, 12 and 24 months after the operation. Hospitalization time, treatment time, complications, and recurrence were compared between the two groups.Results: The VAS and ODI at each observation point of the post-operation were significantly decreased compared with the pre-operation in both groups (P < 0.05). There was no statistically difference of VAS and ODI between the two groups at 1 and 3 months of the post-operation (P > 0.05). However, The VAS and ODI scores in Group TR were significantly lower than that in Group T at 6, 12 and 24 months of the post-operation (P < 0.05). The GPE in group TR was high in the early days, while that at 1 and 3 months after treatment was significantly higher than that in group T (P < 0.05). The recurrence rate in Group TR was lower than that in Group T (P = 0.002). There was no significant difference in hospitalization time, complications, VAS and ODI score at the pre-operation between the two groups (P > 0.05).Conclusion: These findings suggest that TFESI combined with RF could effectively improve the pain and function, and had a long-term satisfactory effect for the treatment of LDH.

scholarly journals Paraplegia after transforaminal epidural steroid injection in a patient with severe lumbar disc herniation - A case report -

2021 ◽  
Vol 16 (1) ◽  
pp. 96-102
Author(s):  
Seok Ho Jeon ◽  
Won Jang ◽  
Sun-Hee Kim ◽  
Yong-Hyun Cho ◽  
Hyun Seok Lee ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Steroid Injection ◽  
Treatment Plan ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Epidural Steroid Injection ◽  
Correct Treatment ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid

Background: Transforaminal epidural steroid injection (TFESI) is a conservative treatment for patients with lumbar disc herniation (LDH). However, there are reports of various complications that can occur after TFESI; among these, paraplegia is a serious complication. Case: A 70-year-old woman who was unable to lie supine due to low back pain exacerbation during back extension underwent TFESI. After injection, there was pain relief and the patient was able to lie supine; however, paraplegia developed immediately. Magnetic resonance imaging confirmed cauda equina syndrome (CES) due to nerve compression from L1–2 LDH. We determined that the patient's LDH was already severe enough to be considered CES and that the TFESI procedure performed without an accurate understanding of the patient's condition aggravated the disease. Conclusions: It is important to accurately determine the cause of pain and disease state of a patient to establish a correct treatment plan before TFESI is performed.

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