Ultrasound-guided caudal epidural steroid injection in chronic radicular low back pain: short-term electrophysiologic benefits.

Autor:	Ibrahim ME; Lecturer of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University. PhD in Physical Medicine, Rheumatology and Rehabilitation, Ismailia, Egypt., Awadalla MA; Professor of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University. PD in Physical Medicine, Rheumatology and Rehabilitation, Ismailia, Egypt., Omar AS; Professor of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University. PD in Physical Medicine, Rheumatology and Rehabilitation, Ismailia, Egypt., Al-Shatouri M; Associate professor of Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Jazyk:	angličtina
Zdroj:	BJR open [BJR Open] 2020 Jan 13; Vol. 2 (1), pp. 20190006. Date of Electronic Publication: 2020 Jan 13 (Print Publication: 2020).
DOI:	10.1259/bjro.20190006
Abstrakt:	Objective: To assess the short-term efficacy of ultrasound-guided caudal epidural steroid injections (ESIs) in improving pain, and nerve function as measured by electrophysiological testing in chronic radicular low back pain. Methods: Patients diagnosed with chronic radicular low back pain were randomized into one of two groups. The injection group ( n = 20) underwent a single ultrasound-guided Caudal ESI of 1 ml of 40 mg ml -1 Triamcinolone Acetonide (Kenacort-A), with local anesthetic. The control group ( n = 20) underwent a 12-session physiotherapy program. Both groups were evaluated before and 2 weeks after the intervention using visual analog scale for pain and electrophysiological testing comprising peroneal and tibial terminal motor latencies and F-response latencies and chronodispersion. Results: Both groups showed significant pain reduction on the visual analog scale after the intervention. The injection group showed a significant reduction in F wave chronodispersion post-treatment (<0.01). In the control group, there were no significant differences in F wave parameters pre- and post-treatment ( p > 0.05). Conclusion: Caudal ESIs were shown to provide short-term improvement of nerve function as evident by improvement in the electrophysiological parameters sensitive to radiculopathy. It was found to be superior to standard physical therapy in this regard. Advances in Knowledge: This work shows a novel electrophysiologic evidence of the short-term efficacy ultrasound-guided caudal ESI. Competing Interests: Competing interests: The authors declare that they have no competing interests. Competing interests: The authors declare that they have no competing interests. (© 2020 The Authors. Published by the British Institute of Radiology.)
Databáze:	MEDLINE
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