Transforaminal epidural clonidine versus corticosteroid for acute lumbosacral radiculopathy due to intervertebral disc herniation

Spine

Volumn 36, Issue 5, 2011, Pages

  Burgher, Abram H ^a   Hoelzer, Bryan C ^b   Schroeder, Darrell R ^b   Wilson, Gregory A ^b   Huntoon, Marc A ^b  

^a Pain Center of Arizona   (United States)

^b MAYO CLINIC   (United States)

Author keywords

clonidine; corticosteroid; epidural injection; Intervertebral disc hernation; pain; radiculopathy

Indexed keywords

CLONIDINE; CORTICOSTEROID; PLACEBO; TRIAMCINOLONE;

ACUTE LUMBOSACRAL RADICULOPATHY; ADULT; ANALGESIA; ANTIINFLAMMATORY ACTIVITY; ARTICLE; CLINICAL ARTICLE; CONSTIPATION; CONTROLLED STUDY; DIZZINESS; DOUBLE BLIND PROCEDURE; DROWSINESS; DRUG SAFETY; FEMALE; HUMAN; INJECTION SITE DISCOMFORT; INTERVERTEBRAL DISK HERNIA; LEG PAIN; LOW BACK PAIN; MALE; NAUSEA; NERVE INJURY; PRIORITY JOURNAL; RADICULAR PAIN; RANDOMIZED CONTROLLED TRIAL; SCORING SYSTEM; SYMPTOM WORSENING; TREATMENT OUTCOME; WEAKNESS; XEROSTOMIA;

ACUTE DISEASE; ADRENAL CORTEX HORMONES; ADULT; AGED; CLONIDINE; FEMALE; HUMANS; INJECTIONS, EPIDURAL; INTERVERTEBRAL DISC DISPLACEMENT; LUMBOSACRAL REGION; MALE; MIDDLE AGED; PAIN MEASUREMENT; PROSPECTIVE STUDIES; RADICULOPATHY; TRIAMCINOLONE;

EID: 79952310323     PISSN: 03622436     EISSN: 15281159     Source Type: Journal    
DOI: 10.1097/BRS.0b013e3181ddd597     Document Type: Article

References (27)

1. Deyo RA, Weinstein JN. Low back pain [see comment]. N Engl J Med 2001;344(5):363-70. (Pubitemid 32107646)
2. Rhee JM, Schaufele M, Abdu WA. Radiculopathy and the herniated lumbar disc. Controversies regarding pathophysiology and management. J Bone Joint Surg Am 2006;88(9):2070-80.
3. Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort [see comment]. JAMA. 2006;296(20):2451-9. (Pubitemid 44791201)
4. Armon C, Argoff CE, Samuels J, et al; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: use of epidural steroid injections to treat radicular lumbosacral pain: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology [see comment]. Neurology 2007;68(10):723-9. (Pubitemid 46667896)
5. Huntoon MA, Martin DP. Paralysis after transforaminal epidural injection and previous spinal surgery [see comment]. Reg Anesth Pain Med 2004;29(5):494-5. (Pubitemid 39221898)
6. Tosteson AN, Skinner JS, Tosteson TD, et al. The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT). Spine 2008;33(19):2108-15.
7. Eisenach JC, De Kock M, Klimscha W. Alpha(2)-adrenergic agonists for regional anesthesia. A clinical review of clonidine (1984-1995). Anesthesiology 1996;85(3):655-74.
8. Walker SM, Goudas LC, Cousins MJ, et al. Combination spinal analgesic chemotherapy: a systematic review [see comment]. Anesth Analg 2002;95(3):674-715. (Pubitemid 35006863)
9. Reuben SS, Buvanendran A. Preventing the development of chronic pain after orthopaedic surgery with preventive multimodal analgesic techniques. J Bone Jt Surg Am Vol 2007;89(6):1343-58.
10. Lavand'homme PM, Eisenach JC. Perioperative administration of the alpha2-adrenoceptor agonist clonidine at the site of nerve injury reduces the development of mechanical hypersensitivity and modulates local cytokine expression. Pain 2003;105(1/2):247-54.
11. Wu CT, Jao SW, Borel CO, et al. The effect of epidural clonidine on perioperative cytokine response, postoperative pain, and bowel function in patients undergoing colorectal surgery. Anesth Analg 2004;99(2):502-9. (Pubitemid 38970426)
12. Liu B, Eisenach JC. Hyperexcitability of axotomized and neighboring unaxotomized sensory neurons is reduced days after perineural clonidine at the site of injury. J Neurophysiol 2005;94(5):3159-67. (Pubitemid 41504758)
13. Romero-Sandoval EA, McCall C, Eisenach JC. Alpha2-adrenoceptor stimulation transforms immune responses in neuritis and blocks neuritis-induced pain. J Neurosci 2005;25(39):8988-94. (Pubitemid 41384467)
14. Romero-Sandoval A, Eisenach JC. Perineural clonidine reduces mechanical hypersensitivity and cytokine production in established nerve injury. Anesthesiology 2006;104(2):351-5.
15. Bogduk N. International Spine Intervention Society Practice Guidelines. San FraNssisco, CA: International Spine Intervention Society; 2004.
16. Carette S, Leclaire R, Marcoux S, et al. Epidural corticosteroid injections for sciatica due to herniated nucleus pulposus [see comment]. N Engl J Med 1997;336(23):1634-40. (Pubitemid 27231317)
17. Karppinen J, Malmivaara A, Kurunlahti M, et al. Periradicular infiltration for sciatica: a randomized controlled trial. Spine 2001;26(9):1059-67. (Pubitemid 32423656)
18. Olmarker K, Rydevik B, Nordborg C. Autologous nucleus pulposus induces neurophysiologic and histologic changes in porcine cauda equina nerve roots [see comment]. Spine 1993;18(11):1425-32. (Pubitemid 23270905)
19. Olmarker K, Rydevik B. Selective inhibition of tumor necrosis factor-alpha prevents nucleus pulposus-induced thrombus formation, intraneural edema, and reduction of nerve conduction velocity: possible implications for future pharmacologic treatment strategies of sciatica. Spine 2001;26(8):863-9. (Pubitemid 32373971)
20. Cohen SP, Bogduk N, Dragovich A, et al. Randomized, doubleblind, placebo-controlled, dose-response, and preclinical safety study of transforaminal epidural etanercept for the treatment of sciatica. Anesthesiology 2009;110(5):1116-26.
21. Tiso RL, Cutler T, Catania JA, et al. Adverse central nervous system sequelae after selective transforaminal block: the role of corticosteroids. Spine J 2004;4(4):468-74. (Pubitemid 38986988)
22. Gazelka HH, Hoelzer BC, Huntoon MA, et al. The effects of clonidine on particulate steroid size. Paper presented at: American Society of Anesthesthiologists, Annual Meeting; October 17-21, 2009; New Orleans, LA. 2009. Manuscript submitted for publication.
23. Farrar JT, Young JP Jr, LaMoreaux L, et al. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001;94(2):149-58. (Pubitemid 33016608)
24. Dworkin RH, Turk DC, Wyrwich KW, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain 2008;9(2):105-21. (Pubitemid 351147828)
25. Riew KD, Yin Y, Gilula L, et al. The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double-blind study. J Bone Jt Surg-Am Volume 2000;82-A(11):1589-93.
26. Riew KD, Park JB, Cho YS, et al. Nerve root blocks in the treatment of lumbar radicular pain. A minimum five-year follow-up. J Bone Jt Surg-Am Vol 2006;88(8):1722-5.
27. Peul WC, van Houwelingen HC, van den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica [see comment]. N Engl J Med 2007;356(22):2245-56. (Pubitemid 46849155)