Predictability of the effects of epidural injection in lumbar spinal stenosis by assessment of lumbar MRI scans

Epidural Glucocorticoid Injections for Spinal Stenosis

50 Studies Every Anesthesiologist Should Know ◽

10.1093/med/9780190237691.003.0038 ◽

2018 ◽

pp. 200-204

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Epidural Injection ◽

Systemic Absorption ◽

Lumbar Stenosis ◽

Epidural Injections ◽

Hypothalamic Pituitary Axis ◽

Lumbar Spinal

This case focuses on using an epidural on spinal stenosis by asking the question: What is the effectiveness of epidural injections of glucocorticoids plus anesthetic compared with injections of anesthetic alone in patients with lumbar spinal stenosis? This study demonstrated that epidural injection containing glucocorticoids for the treatment of lumbar stenosis offered minimal or no benefit over epidural injection of lidocaine alone at 6 weeks. Systemic absorption of glucocorticoids and suppression of the hypothalamic-pituitary axis were demonstrated among patients who received epidural injections containing glucocorticoids.

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Artificial Intelligence Algorithm-Based Lumbar and Spinal MRI for Evaluation of Efficacy of Chinkuei Shin Chewan Decoction on Lumbar Spinal Stenosis

Contrast Media & Molecular Imaging ◽

10.1155/2021/2700452 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Yuefeng Zhu ◽

Tao Wu ◽

Wenhao Wang ◽

Chengchen Cai ◽

Bin Zhu ◽

...

Keyword(s):

Artificial Intelligence ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Control Group ◽

Research Subjects ◽

Registration Algorithm ◽

Lumbar Mri ◽

Magnetic Resonance Imaging Mri ◽

Lumbar Spinal ◽

Experimental Group

The study aimed to explore the application value of lumbar Magnetic Resonance Imaging (MRI) images processed by artificial intelligence algorithms in evaluating the efficacy of chinkuei shin chewan decoction (a traditional Chinese medicine to nourish the kidney) in the treatment of lumbar spinal stenosis (LSS). Specifically, 110 LSS patients admitted to the hospital were selected as the research subjects. They were randomly divided into the control group (n = 55) and experimental group (n = 55) according to different treatment methods. The control group was treated with traditional medicine, and the experimental group additionally took chinkuei shin chewan decoction on its basis. Based on the traditional U-net algorithm, a U-net registration algorithm based on artificial intelligence was designed by introducing the information entropy theory, and the algorithm was applied to the lumbar MRI image evaluation of LSS patients. Compared with the traditional U-net algorithm, the artificial intelligence-based U-net registration algorithm had a decreased noise level P < 0.05 , the Jaccard (J) value (0.84) and the Dice value (0.93) increased significantly versus the traditional algorithm (J = 0.63, Dice = 0.81), and the characteristics of the image were more accurate. Before treatment, the Oswestry Disability Index (ODI) scores of the experimental group and the control group were 44.32 ± 6.45 and 43.32 ± 5.45, respectively. After treatment, the ODI scores of the two groups were 10.21 ± 5.05 and 17.09 ± 5.23, respectively. Both showed significant improvement, while the improvement of the experimental group was more obvious than that of the control group P < 0.05 . The overall effective rates of the two groups of patients were 96.44% and 82.47%, respectively, and the experimental group was significantly higher than the control group P < 0.05 . Under the U-net registration algorithm based on artificial intelligence, the diagnostic accuracy of lumbar MRI in the experimental group was 94.45%, significantly higher than 67.5% before the introduction of the algorithm P < 0.05 . In conclusion, chinkuei shin chewan decoction are effective for the treatment of LSS, and lumbar MRI based on the artificial intelligence U-net registration algorithm can evaluate the efficacy of LSS well and is worthy of promotion.

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