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Transforaminal steroid injection for lumbar radicular pain proves superior to placebo
Date:7/29/2010

IMST) to test for a systemic effect; or intramuscular injection of normal saline (IMNS) to test for non-specific (placebo) effects.

A total of 150 patients were enrolled in the study. The inclusion criteria were adult patients, capable of providing consent and capable of complying with the outcome instruments used, with pain radiating into the lower limb of a lancinating, burning, stabbing, or electric quality, limitation of straight-leg-raise to less than 30 degrees, and demonstration of a disc herniation by CT or MRI at a segmental level consistent with the clinical features. Pain of the appropriate quality was the primary indication for treatment. Neurological signs of radiculopathy were not required, but served to consolidate the diagnosis when they were present. All patients were classified as eligible for surgery, meaning that surgery would be the next intervention if injections did not relieve the pain.

Exclusion criteria were foraminal stenosis, severe motor deficit, a history of substance abuse, previous surgery at the affected segmental level, or conditions that rendered an injection unsafe, such as pregnancy, recent infection, or spinal deformity. Patients were not excluded on the basis of duration of pain.

After randomization, the five treatment-groups showed no statistically significant differences in demographic features such as age, gender balance, segmental levels treated, or the proportion of acute or chronic cases.

A standard volume and dose were used for each patient for each type of injection. Patients allocated for TFST received 0.75ml of 0.5% bupivacaine followed by 1.75ml of triamcinalone in a concentration of 40mg/ml. The TFLA group received 2 ml of 0.5% bupivacaine. The TFNS group received 2 ml of the saline agent. Patients in the IMST received 1.75 ml of triamcinolone (40mg/ml). Patients allocated for IMNS received a volume of 2 ml.

The primary outcome measure was the proportion of patients wh
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Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

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