scholarly journals SPINAL STENOSIS

2018 ◽  
Vol 25 (09) ◽  
pp. 1323-1327
Author(s):  
Saeed Ahmad ◽  
Haseeb Hussain ◽  
Ashfaq Ahmed ◽  
Rizwan Akram ◽  
Ijaz Ahmed ◽  
...  
Keyword(s):  
Single Dose ◽  
Spinal Stenosis ◽  
Local Anesthesia ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Lower Back ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Epidural Steroid

Introduction: Spinal stenosis causing lower back pain and radiculopathy andit is the most common cause of patient admission at Spine centre as compared to other spinepathologies. Most common complaint in the Spine outpatient department or hospital admissionsDifferent modalities have been applied with time for its management. Among them Epiduralsteroid injection is also. Objectives: “To Compare three doses of epidural steroid injection withsingle dose of epidural steroid injection for Lumbar Radicular pain in spinal stenosis patients.”Study Design: Prospective study. Setting: Ghurki Trust Teaching Hospital, Lahore, Pakistan.Period: Jan 2016 to Dec 2016. Materials and Methods: 95 patients with lumbar radicular paindue to spinal stenosis were randomly allocated into 2 groups. In Group A, 42 patients were given120 mg of Depo-medrol (40 mg per day for 3 days) along with local anesthesia and in group B,43 patients were given 40 mg of Depo-medrol with local anesthesia as a single dose. Both GroupA and Group B were matched in terms of age and gender. On visual analogue scoring, pain wasassessed after 2 weeks, 3 months and 6 months. Results: In Group A (3 doses of depomedrol)VAS improvement at 2 weeks, 3 months and 6 months were more than group B (single dose ofdepomedrol) which was statistically significant (p < 0.05). There were no major complicationslike epidural hematoma or abscess formation in both groups. The overall minor complicationslike flushing, transient hyperglycemia and headache due to CSF hypotension were more inGroup A than Group B but statistics shows no significant difference. All the adverse eventsresolved within few days without any significant morbidity and subsequent hospitalizations.Conclusion: Epidural steroid injection is excellent modality in the treatment of lower back painwith radiculopathy. Moreover 3 doses have greater effect in relieving pain as compared to singledose. There is no increase risk of complications by increasing dose.

scholarly journals Outcome of Transforaminal Epidural Steroid Injection According to the Severity of Lumbar Foraminal Spinal Stenosis

2018 ◽  
Vol 1 (21;1) ◽  
pp. 67-72 ◽  
Author(s):  
Min Cheol Chang, MD Chang
Keyword(s):  
Spinal Stenosis ◽  
Rating Scale ◽  
Steroid Injection ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
University Hospital ◽  
Group A ◽  
Transforaminal Epidural Steroid Injection ◽  
Lumbar Radicular Pain ◽  
Epidural Steroid

Background: Lumbar foraminal spinal stenosis (LFSS) is a common cause of radicular pain in the lower extremities. Transforaminal epidural steroid injection (TFESI) is being used widely for controlling radicular pain induced by LFSS. The efficacy of TFESI has been demonstrated in previous studies. However, no study has evaluated the outcome of TFESI according to the severity of LFSS. Objective: In this study, we evaluated the outcome of TFESI in patients with chronic lumbar radicular pain due to LFSS according to the severity of LFSS by using magnetic resonance imaging (MRI). Study Design: A prospective observational study. Setting: A university hospital. Methods: Sixty patients with chronic lumbar radicular pain due to LFSS were included in this prospective study and received TFESI at our university hospital. Three patients were lost to followup. On the basis of sagittal lumbar MRI findings, we assigned patients with mild to moderate LFSS to group A (n = 31) and those with severe LFSS to group B (n = 26). Pain intensity was evaluated using a numeric rating scale (NRS) before treatment and at 1, 2, and 3 months after treatment. Results: Compared to pretreatment NRS scores, a significant decrease in NRS scores was observed in patients in both groups at 1, 2, and 3 months after treatment (P = 0.000). However, reductions in the NRS scores over time were significantly larger in group A (P = 0.023). Three months after treatment, 27 patients (87.1%) in group A and 11 patients (42.3%) in group B reported successful pain relief (pain relief of ≥ 50%). Limitations: This study had a small number of patients. Conclusions: After TFESI, chronic lumbar radicular pain was significantly reduced regardless of the severity of LFSS, and the effects of TFESI were sustained for at least 3 months after treatment. However, the outcome of TFESI was superior in the group with a mild to moderate degree of LFSS, compared to the group with a severe degree of LFSS. We believe that our study provides useful information for establishing a treatment plan for radicular pain due to LFSS. Key words: Lumbar foraminal spinal stenosis, transforaminal epidural steroid injection, disease severity, magnetic resonance imaging, numeric rating scale, corticosteroids

scholarly journals Comparison of Epidural Steroid Injections with Conservative Management in Patients with Lumbar Radiculopathy

2014 ◽  
Vol 26 (1) ◽  
pp. 09-11
Author(s):  
Md Mahmudur Rahman ◽  
Md Imamur Rashid ◽  
Nadia Rahman ◽  
MA Shakoor
Keyword(s):  
Back Pain ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Leg Pain ◽  
Therapeutic Exercises ◽  
Group A ◽  
Group B ◽  
Epidural Steroid

Pain in the back is the most common of all chronic pain disorders. Back pain and sciatica, or leg pain originating from injury to or pressure on the sciatic nerve, are major causes of disability in adults, occurring in 15% to 20% of the working-age population annually and 70% to 90% of adults at some point in their lives. Men and women are affected equally. The study was conducted prospectively in 60 patients of 18 to 60 years of age with documented chronic low back pain with sciatica. Thirty patients were treated in group-A with conservative treatment (NSAID+ therapeutic exercises+ superficial thermotherapy and ADL instruction) plus epidural steroid injection and 30 samples were treated in group B with conservative treatment only. Epidural steroid injection treatment group is significantly improved than conservative treatment group (p<0.05). There was more improvement of pain in group –A than in Group B ( p= 0.007) and SLR was more increased in group –A than group-B (p=0.03). So, epidural steroid injection is a effective treatment for lumber rediculopathy especially in acute phase. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21302 Medicine Today 2014 Vol.26(1): 09-11

scholarly journals Comparison of Three Doses of Epidural Steroid Injection with Single Dose of Epidural Steroid Injection for Lumbar Radicular pain in Spinal Stenosis Patients

2016 ◽  
Vol 6 (1_suppl) ◽  
pp. s-0036-1582855-s-0036-1582855
Author(s):  
Saeed Ahmad ◽  
Amer Aziz ◽  
Ijaz Ahmed ◽  
Shahzad Javed ◽  
Naeem Ahmed ◽  
...  
Keyword(s):  
Single Dose ◽  
Spinal Stenosis ◽  
Steroid Injection ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Lumbar Radicular Pain ◽  
Epidural Steroid

scholarly journals The clinical efficacy of three application methods of local anesthesia in percutaneous vertebroplasty: A retrospective single-center cohort study

2020 ◽  
Author(s):  
Xinjie Liang ◽  
Weiyang Zhong ◽  
Tianji Huang ◽  
Xiaoji Luo
Keyword(s):  
Local Anesthesia ◽  
Percutaneous Vertebroplasty ◽  
Vertebral Compression Fractures ◽  
Blood Oxygen Saturation ◽  
Cement Injection ◽  
Significant Difference ◽  
Group A ◽  
Intraoperative Pain ◽  
Application Methods ◽  
Group B

Abstract Background: Although various studies have described the methods of anaesthesia in percutaneous vertebroplasty(PV) in treating osteoporotic vertebral compression fractures (OVCFs), there is still no consensus on the optimal treatment regimen.The study aims to investigate the efficacy of three application methods of local anesthesia in PV treating OVCFs.Methods：A total of 96 patients of OVCFs were reviewed and divided into three groups(A: lidocaine, B: ropivacaine, C: lidocaine+ropivacaine). The visual analog scale(VAS), blood pressure(BP), heart rate(HR), blood oxygen saturation(BOS), surgery time were recorded at the points of before puncture, puncture, cement injection, and after surgery.Results: The mean age of the patients was 74.13±7.02 years in group A, 70.47±5.50 years in group B, and 73.07±7.51 years respectively without significant difference. No significant differences were found in the sex, age, hospital stay, surgery time, blood loss, and cement volume. During the period of before surgery and 4-hour after surgery, the VAS in group C decreased significantly at the period of puncture, cement injection, immediately after surgery. Overall, the systolic BP, diastolic BP, HR, BOS during the different period among the groups, there were no significant differences except the HR in the period of the puncture in group C was slower than that in other groups and HR in the period of cement injection in the group A was faster than other two groups. A correlation was observed between the VAS and the period of cement injection(r=0.5358), after surgery(r=0.5775) in group C.Conclusion: In conclusion, the use of the lidocaine in combination with ropivacaine could relieve the effective intraoperative pain in PV treating OVCFs patients which is reliable and safe.

scholarly journals A Comparative Study of Steroid Injection With or Without Lignocaine in Treating Frozen Shoulder

2018 ◽  
Vol 5 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Alok Pandey ◽  
B Shrestha ◽  
K M Shrestha
Keyword(s):  
Range Of Motion ◽  
Steroid Injection ◽  
Frozen Shoulder ◽  
Equal Frequency ◽  
Steroid Injections ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Dominant Side

BACKGROUND: Treatment of Frozen shoulder (Adhesive Capsulitis) is mainly nonoperative. Intra-articular steroid injections and physiotherapy are one of the most effective and useful treatment. Even though intra-articular steroid injections are very effective in inflammatory phase of the disease; patients are reluctant to move their affected shoulder for fear of pain. Thus, they do not follow exercise program properly resulting in poor outcomes.OBJECTIVE: If pain could be reduced, outcome of treatment can improve. Lignocaine, when combined with steroid injection, plays an important role in immediate improvement of pain and active range of motion thereby increasing the overall result. MATERIALS & METHODS: 100 patients with frozen shoulder were selected according to predetermined inclusion and exclusion criteria. After randomization by sealed envelope technique, patients were divided into Group A and Group B. Group A patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of 1% Lignocaine, and Group B patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of Distilled water in the affected shoulder via standard posterior approach. Then half an hour of standard shoulder range of motion (ROM) exercise regimen was performed under supervision. Pre injection and post injection pain level was scored by Visual Analogue Score (VAS) and Subjective satisfaction score (SSS). Shoulder exercises were taught and home based physiotherapy was carried out by patients themselves. They were also prescribed oral analgesics for 5 days and were followed at 1, 3, and 6 weeks. At every follow up visit, they were assessed for improvement via Constant-Murley Score (CMS).RESULTS: The mean age of this study in group A and group B was 56.46 years (SD 10.05) and 57.18 years (SD 8.87) respectively (P0.70). There were 31 male and 19 female in group A as compared to group B where there was 26 males and 24 females (P0.41). In both the groups, maximum number of patients presented at around 10 weeks. In both the groups left side dominated right side with equal frequency (33 left sides and 17 right sides) (P 1.00) and non dominant side outnumbered dominant side with near equal frequency (P 1.00). After the intervention, excellent result in SSS was observed only in group A whereas maximum patients of Group B had only fair result (42 patients). There was statistically significant difference between two groups in terms of pain; Activity of daily living (ADL) and Range of motion (ROM). Patients in group A were able to carry more weight than group B.   In CMS 1 and 6 week total, there was statistically highly significant difference between two groups. CONCLUSION: Even though steroid and physical exercises play important role in managing frozen shoulder, addition of lignocaine to steroid injection seems to be helpful. It relieves immediate pain on movement and improves exercise compliance thereby improving early outcomes. Evaluation of long term benefits of lignocaine injection needs further studies. Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, Page: 22-28 

Efficacy and Safety of Fenofibrate in Uncomplicated Hyperbilirubinemia in Newborn: A Randomized Trial, with a 6-month Follow-up

2020 ◽  
pp. 37-42
Author(s):  
Jayendra R. Gohil ◽  
Vishal S. Rathod ◽  
Bhoomika D. Rathod
Keyword(s):  
Single Dose ◽  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Control Group ◽  
Term Neonates ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: To study the effect and safety of Fenofibrate in uncomplicated hyperbilirubinemia in newborn with 6-month follow-up. Materials and Methods: This is a randomized controlled clinical trial conducted in 60 normal term neonates admitted for uncomplicated hyperbilirubinemia in NICU at Sir T G Hospital, Bhavnagar from January 2012 to December 2012. The data included: age, sex, total serum bilirubin (TSB), weight and duration of phototherapy. All neonates enrolled in the study received phototherapy. They were divided in two groups of 30 each: control group A and group B receiving Fenofibrate (100 mg/kg single dose). There was statistically insignificant difference between the parameters of age, sex, weight and TSB between the two groups at hospitalization. Data was analyzed by using appropriate statistical methods. Results: Mean values for total serum bilirubin in Fenofibrate group B at 24 and 48 hours after admission were significantly lower than those for control group A (p<0.0001,  p=0.0001). There was no significant difference in fall of TSB between 24 and 48 hours. The mean duration of phototherapy in Fenofibrate group (44.8h: 24-72h) was significantly shorter than that in control group (55.2 h: 24‐96 h) (P=0.02). There were no side effects of the drug observed during the study and during 6 months follow up period. Conclusion: Fenofibrate as a single 100 mg/kg dose in healthy full term neonates, is effective and a safe drug (till six-month follow-up) for neonatal hyperbilirubinemia, that can decrease the time needed for phototherapy and hence hospitalization. Effect of a single dose seems to wane after 24 hours.

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