Abstract | OBJECTIVES: METHODS: This retrospective observational study included 806 patients with lumbar radiculopathy and corresponding MRI or CT abnormalities of the lumbar spine, who were matched using the propensity score method, yielding two cohorts of 209 patients each. Pain intensity was evaluated prior to the procedure using a pain numerical rating scale (NRS) with range 0-10. Reevaluation took place 1 day and 4 weeks post-injection. Logistic regression analysis and cubic splines applied to generalized additive models were implemented to assess the differences in pain reduction after ESI in the analyzed patient groups. RESULTS: Four weeks post-injection, the overall chance of ≥ 50% pain reduction was lower in the dexamethasone group than that in the triamcinolone group (odds ratio [OR] = 0.55; p < 0.012). In the dexamethasone cohort, the intensity of baseline pain and the presence of a herniated intervertebral disc in the infiltrated segment were both significant and independent predictors of ≥ 50% pain relief. Patients with baseline NRS score ≥ 7 points had markedly less chance of ≥ 50% pain relief than patients with NRS score < 7 (OR = 0.53; p < 0.032), whereas disc herniation increased the chances more than twofold (OR = 2.29; p < 0.044). There was no significant correlation between the effectiveness of triamcinolone and any analyzed concomitant variables. CONCLUSIONS: KEY POINTS:
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Authors | Marek Tagowski, Zbigniew Lewandowski, Jürg Hodler, Thomas Spiegel, Gerhard W Goerres |
Journal | European radiology
(Eur Radiol)
Vol. 29
Issue 7
Pg. 3379-3389
(Jul 2019)
ISSN: 1432-1084 [Electronic] Germany |
PMID | 30887207
(Publication Type: Journal Article, Observational Study)
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Chemical References |
- Glucocorticoids
- dexamethasone 21-phosphate
- Dexamethasone
- Lidocaine
- Triamcinolone Acetonide
- Bupivacaine
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Topics |
- Adult
- Aged
- Back Pain
(drug therapy, etiology)
- Bupivacaine
(administration & dosage)
- Dexamethasone
(administration & dosage, analogs & derivatives, therapeutic use)
- Female
- Glucocorticoids
(administration & dosage, therapeutic use)
- Humans
- Injections, Epidural
(methods)
- Intervertebral Disc Displacement
(complications)
- Lidocaine
(administration & dosage)
- Lumbar Vertebrae
(diagnostic imaging)
- Male
- Middle Aged
- Pain Management
(methods)
- Pain Measurement
(methods)
- Radiculopathy
(complications, drug therapy)
- Radiography, Interventional
(methods)
- Retrospective Studies
- Spinal Stenosis
(complications)
- Tomography, X-Ray Computed
(methods)
- Treatment Outcome
- Triamcinolone Acetonide
(administration & dosage, therapeutic use)
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