Archive | Epidurals

Research – General Epidural Steroid Injections

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Adverse Effects

1 - Epidural steroid injections do not induce weight gain

  • Curr Drug Saf. 2007 May;2(2):113-6.
  • Prospective evaluation of 100 patients who received a series of three lumbar ESIs (once a month for three months)
  • 40 mg methylprednisolone acetate (Depo-Medrol) for each injection
  • No significant change in weight gain
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Research – Lumbar Radiofrequency Neurotomy

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6 - Effectiveness of repeated radiofrequency neurotomy for lumbar facet pain

  • Spine. 2004 Nov 1;29(21):2471-3.
  • Each RF neurotomy had a mean duration of relief = 10.5 months
  • The repeat ablations were successful more than 85% of the time (and some of the patients had up to 4 repeated procedures)

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Research – Cervical Radiofrequency Neurotomy

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2 – Radiofrequency medial branch neurotomy in litigant and nonlitigant patients with cervical whiplash: a prospective study

  • Spine. 2001 Jun 15;26(12):E268-73
  • 46 patients who failed 20 weeks of conservative care
  • Both groups had significant improvement in pain scores and reported symptoms.  No significant difference between the groups was seen.
  • “…the potential for secondary gain in patients who have cervical facet arthropathy as a result of a whiplash injury does NOT influence response to treatment.”

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Research – Cervical Transforaminal Epidural Steroid Injections

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3 - Transforaminal steroid injections in the treatment of cervical radiculopathy. A prospective outcome study

  • Acta Neurochir (Wien). 2005 Oct;147(10):1065-70
  • Reduced need for operative treatment (because of radicular and neck pain relief).
  • Routine transforaminal injection treatment prior to surgery seems rewarding, but the complication risk must be taken into consideration.”

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Research – Lumbar Transforaminal Epidural Steroid Injections

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12 - Comparison of the effectiveness of interlaminar and bilateral transforaminal epidural steroid injections in treatment of patients with lumbosacral disc herniation and spinal stenosis

  • Clin J Pain. 2009 Mar-Apr;25(3):206-10
  • Looked at patients with axial low back pain only (no radiculopathy)
  • In patients with spinal stenosis (SS), the bilateral transforaminal ESI produced better results than the interlaminar approach.
  • Authors believe this was because there is more scaring with SS, and this limits the amount of injectate to the ventral epidural space.

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