Epidural corticosteroid injections for sciatica due to herniated nucleus pulposus

The New England Journal of Medicine
S CaretteC Blanchette

Abstract

Although epidural corticosteroid injections are commonly used for sciatica, their efficacy has not been established. In a randomized, double-blind trial, we administered up to three epidural injections of methylprednisolone acetate (80 mg in 8 ml of isotonic saline) or isotonic saline (1 ml) to 158 patients with sciatica due to a herniated nucleus pulposus. All patients had Oswestry disability scores higher than 20 (on a scale of 1 to 100, with scores of 20 or less indicating minimal disability, and higher scores greater disability). At three weeks, the Oswestry score had improved by a mean of -8.0 in the methylprednisolone group and -5.5 in the placebo group (95 percent confidence interval for the difference, -7.1 to 2.2). Differences in improvements between the groups were not significant, except for improvements in the finger-to-floor distance (P=0.006) and sensory deficits (P=0.03), which were greater in the methylprednisolone group. After six weeks, the only significant difference was the improvement in leg pain, which was greater in the methylprednisolone group (P=0.03). After three months, there were no significant differences between the groups. The Oswestry score had improved by a mean of -17.3 in the methylprednisolon...Continue Reading

References

Jan 1, 1977·Acta Orthopaedica Scandinavica·W SnoekB Jørgensen
Jan 1, 1976·International Journal of Health Services : Planning, Administration, Evaluation·M BergnerJ R Morris
Mar 1, 1989·Medical Care·L E KazisR F Meenan
Jul 1, 1989·Archives of Neurology·S E Abram
Dec 1, 1987·British Journal of Rheumatology·J A MathewsY Sittampalam
Feb 4, 1988·The New England Journal of Medicine·J W Frymoyer
Aug 1, 1988·British Journal of Rheumatology·M G RidleyR Grahame
Oct 28, 1985·The Medical Journal of Australia·N Bogduk, D Cherry
Jun 16, 1973·British Medical Journal·T F DilkeR Grahame
Feb 1, 1984·British Journal of Rheumatology·L KlenermanS Peskett
Aug 1, 1980·Anesthesia and Analgesia·T J DelaneyA Butler
May 1, 1962·Annals of Physical Medicine·P J BARRY, P H KENDALL

❮ Previous
Next ❯

Citations

Oct 29, 1998·Arthritis Care and Research : the Official Journal of the Arthritis Health Professions Association·C RivestR N Jamison
Dec 21, 2006·Der Orthopäde·O LinhardtJ Grifka
Aug 9, 2003·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Anders LundinLars Samuelsson
Apr 19, 2008·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·L A C MachadoJ H McAuley
Apr 24, 2009·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Suhayl TafazalPhilip Sell
Nov 30, 2010·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·M ClearyA R Poynton
Sep 17, 2011·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Michel BenoistGilles Hayem
Aug 10, 2006·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Andreas VeihelmannH J Refior
Sep 22, 2000·Current Review of Pain·V C Anderson, Z Israel
Jan 12, 2007·Current Pain and Headache Reports·David M Sibell, Juergen M Fleisch
Nov 1, 2008·Current Pain and Headache Reports·James J Chien, Zahid H Bajwa
Jan 8, 2009·Current Pain and Headache Reports·Jai Sethee, James P Rathmell
Jan 8, 2009·Current Pain and Headache Reports·Charles E Argoff, Cathy Sims-O'Neill
May 27, 2009·Current Reviews in Musculoskeletal Medicine·Kimberley Middleton, David E Fish
Mar 1, 2012·Translational Behavioral Medicine·Randy S RothDavid A Williams
Feb 19, 2004·Journal of Manipulative and Physiological Therapeutics·Richard E ErhardM Vignovic
Mar 8, 2005·The Spine Journal : Official Journal of the North American Spine Society·Robert F McLainNagy A Mekhail
Nov 1, 2003·The Spine Journal : Official Journal of the North American Spine Society·Stuart M WeinsteinUNKNOWN NASS
Jun 19, 2013·International Journal of Technology Assessment in Health Care·Hyun Jin ChoiByung-Joo Park
Sep 11, 2013·Nature Reviews. Rheumatology·David Borenstein
Oct 27, 1997·The New England Journal of Medicine·J D Pritikin
Oct 8, 1998·The New England Journal of Medicine·P G Shekelle
Feb 15, 2001·The New England Journal of Medicine·R A Deyo, J N Weinstein
Jan 11, 2002·The Clinical Journal of Pain·R M Bernstein
Jan 2, 2001·Journal of Spinal Disorders·P C VroomenJ A Knottnerus
Nov 14, 2000·Spine·J C Fairbank, P B Pynsent
Mar 10, 2001·Spine·P J NelemansF Sturmans
Jan 24, 2002·Spine·Laxmaiah Manchikanti, Vijay Singh
Aug 15, 2002·Journal of Spinal Disorders & Techniques·Jeffrey C WangJim A Youssef
Apr 8, 2003·Journal of Spinal Disorders & Techniques·Thomas M LarkinSteven Cohen
Jun 15, 2006·The Clinical Journal of Pain·YiLi Zhou, Salahadin Abdi
Feb 8, 2007·Journal of Spinal Disorders & Techniques·Mohamed Maged Mokhemer MohamedMuhamed Chaudary

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.