The Use of Lumbar Epidural/Transforaminal Steroids for Managing Spinal Disease
| Autor: | Garrett S. Hyman, Irene A. Young, Llewellyn N. Packia-Raj, Andrew J. Cole |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Injections Epidural Spinal disease law.invention Lumbar Randomized controlled trial law Humans Medicine Orthopedics and Sports Medicine Glucocorticoids Sciatica Lumbar Vertebrae business.industry Epidural steroid injection Leg pain medicine.disease Predictive value Surgery Treatment Outcome Radicular pain Anesthesia Spinal Diseases medicine.symptom business Low Back Pain |
| Zdroj: | Journal of the American Academy of Orthopaedic Surgeons. 15:228-238 |
| ISSN: | 1067-151X |
| Popis: | Lumbar epidural steroid injections are used to manage low back and leg pain (ie, sciatica). Utilization of the procedure is increasing, with Medicare spending for lumbar epidural procedures topping $175 million annually. Few prospective randomized controlled trials have clearly demonstrated the efficacy of epidural steroid injections; many have shown conflicting results. Several studies show favorable short-term outcomes with epidural steroid injection for radicular pain, but less conclusive results are achieved >6 months. Methodologic flaws limit interpretation of results from most scientific studies. As a tool for predicting surgical outcome, epidural spinal injection has been found to have a sensitivity between 65% and 100%, a specificity between 71% and 95%, and a positive predictive value as high as 95% for 1-year surgical outcome. Despite inconclusive evidence, when weighing the surgical alternatives and associated risk, cost, and outcomes, lumbar epidural steroid injections are a reasonable nonsurgical option in select patients. |
| Databáze: | OpenAIRE |
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