Comparative effectiveness of lumbar transforaminal epidural steroid injections with particulate versus nonparticulate corticosteroids for lumbar radicular pain due to intervertebral disc herniation: A prospective, randomized, double-blind trial

Pain Medicine (United States)

Volumn 15, Issue 4, 2014, Pages 548-555

  Kennedy, David J ^a   Plastaras, Christopher ^b   Casey, Ellen ^c   Visco, Christopher J ^d   Rittenberg, Joshua D ^e   Conrad, Bryan ^f   Sigler, James ^g   Dreyfuss, Paul ^h  

^a STANFORD UNIVERSITY   (United States)

^b UNIVERSITY OF PENNSYLVANIA   (United States)

^c NORTHWESTERN UNIVERSITY   (United States)

^d Och Spine at New York Presbyterian Hospitals   (United States)

^e KAISER PERMANENTE   (United States)

^f Nike   (United States)

^g UNIVERSITY OF KANSAS   (United States)

^h UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

Author keywords

Corticosteroid; Dexamethasone; Disc herniation; Lumbar; Particulate; Radicular pain; Radiculopathy; Transforaminal epidural injection; Triamcinolone

Indexed keywords

DEXAMETHASONE; MUSCLE RELAXANT AGENT; NONSTEROID ANTIINFLAMMATORY AGENT; OPIATE; PARACETAMOL; STEROID; TRIAMCINOLONE; GLUCOCORTICOID;

ADULT; ANALGESIA; ARTICLE; CHIROPRACTIC; COMPARATIVE EFFECTIVENESS; CONSERVATIVE TREATMENT; CONTROLLED STUDY; CORTICOSTEROID THERAPY; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; EPIDURAL DRUG ADMINISTRATION; FEMALE; FOLLOW UP; HUMAN; LOW BACK PAIN; LUMBAR DISK HERNIA; LUMBAR TRANSFORAMINAL EPIDURAL INJECTION; MAJOR CLINICAL STUDY; MALE; MASSAGE; MCGILL PAIN QUESTIONNAIRE; MULTICENTER STUDY; MULTIPLE CYCLE TREATMENT; NUMERIC RATING SCALE; OSWESTRY DISABILITY INDEX; OUTCOME ASSESSMENT; PAIN ASSESSMENT; PHYSIOTHERAPY; PROSPECTIVE STUDY; RADICULAR PAIN; RANDOMIZED CONTROLLED TRIAL; RATING SCALE; REPEATED DRUG DOSE; TREATMENT DURATION; TREATMENT FAILURE; UNILATERAL RADICULAR PAIN; CLINICAL TRIAL; COMPLICATION; INTERVERTEBRAL DISK HERNIA; LUMBAR VERTEBRA; MIDDLE AGED; RADICULOPATHY; TREATMENT OUTCOME; YOUNG ADULT;

ADULT; DEXAMETHASONE; DOUBLE-BLIND METHOD; FEMALE; GLUCOCORTICOIDS; HUMANS; INJECTIONS, EPIDURAL; INTERVERTEBRAL DISC DISPLACEMENT; LUMBAR VERTEBRAE; MALE; MIDDLE AGED; RADICULOPATHY; TREATMENT OUTCOME; TRIAMCINOLONE; YOUNG ADULT;

EID: 84898025155     PISSN: 15262375     EISSN: 15264637     Source Type: Journal    
DOI: 10.1111/pme.12325     Document Type: Article

References (33)

1. Chou R, Atlas SJ, Stanos SP, Rosenquist RW. Nonsurgical interventional therapies for low back pain: A review of the evidence for an American Pain Society clinical practice guideline. Spine 2009;34:1078-1093.
2. Derby R, Lee S-H, Kim B-J, Chen Y, Seo KS. Complications following cervical epidural steroid injections by expert interventionalists in 2003. Pain Physician 2004;7:445-449.
3. Kennedy DJ, Dreyfuss P, Aprill CN, Bogduk N. Paraplegia following image-guided transforaminal lumbar spine epidural steroid injection: Two case reports. Pain Med 2009;10:1389-1394.
4. Wybier M, Gaudart S, Petrover D, Houdart E, Laredo J-D. Paraplegia complicating selective steroid injections of the lumbar spine. Report of five cases and review of the literature. Eur Radiol 2009;20:181-189.
5. Lyders EM, Morris PP. A case of spinal cord infarction following lumbar transforaminal epidural steroid injection: MR imaging and angiographic findings. Am J Neuroradiol 2009;30:1691-1693.
6. Glaser SE, Falco F. Paraplegia following a thoracolumbar transforaminal epidural steroid injection. Pain Physician 2005;8:309-314.
7. Huntoon MA, Martin DP. Paralysis after transforaminal epidural injection and previous spinal surgery. Reg Anesth Pain Med 2004;29:494-495.
8. Baker R, Dreyfuss P, Mercer S, Bogduk N. Cervical transforaminal injection of corticosteroids into a radicular artery: A possible mechanism for spinal cord injury. Pain 2003;103:211-215.
9. Sayre PA, Burr Ridge IL, Glaser SE. Root cause analysis of paraplegia following transforaminal epidural steroid injections: The "unsafe" triangle. Pain Physician 2010;13:237-244.
10. Murthy NS, Maus TP, Behrns CL. Intraforaminal location of the great anterior radiculomedullary artery (artery of Adamkiewicz): A retrospective review. Pain Med 2010;11:1756-1764.
11. Kroszczynski AC, Kohan K, Kurowski M, Olson TR, Downie SA. Intraforaminal location of thoracolumbar anterior medullary arteries. Pain Med 2013;14:808-812.
12. Derby R, Lee SH, Date ES, Lee JH, Lee CH. Size and aggregation of corticosteroids used for epidural injections. Pain Med 2008;9:227-234.
13. Benzon HT, Chew TL, McCarthy RJ, Benzon HA, Walega DR. Comparison of the particle sizes of different steroids and the effect of dilution: A review of the relative neurotoxicities of the steroids. Anesthesiology 2007;106:331.
14. Dawley JD, Moeller-Bertram T, Wallace MS, Patel PM. Intra-arterial injection in the rat brain: Evaluation of steroids used for transforaminal epidurals. Spine 2009;34:1638-1643.
15. Okubadejo GO, Talcott MR, Schmidt RE, etal. Perils of intravascular methylprednisolone injection into the vertebral artery. An animal study. J Bone Joint Surg Am 2008;90:1932-1938.
16. Depalma MJ, Stout A, Kennedy DJ. Corticosteroid choice for epidural injections. PM R 2013;5:524-532.
17. Dreyfuss P, Baker R, Bogduk N. Comparative effectiveness of cervical transforaminal injections with particulate and nonparticulate corticosteroid preparations for cervical radicular pain. Pain Med 2006;7:237-242.
18. Lee JW, Park KW, Chung SK, etal. Cervical transforaminal epidural steroid injection for the management of cervical radiculopathy: A comparative study of particulate versus non-particulate steroids. Skeletal Radiol 2009;38:1077-1082.
19. Shakir A, Ma V, Mehta B. Comparison of pain score reduction using triamcinolone vs. dexamethasone in cervical transforaminal epidural steroid injections. Am J Phys Med Rehabil Assoc Acad Physiatr 2013;92:768-775.
20. Park CH, Lee SH, Kim BI. Comparison of the effectiveness of lumbar transforaminal epidural injection with particulate and nonparticulate corticosteroids in lumbar radiating pain. Pain Med 2010;11:1654-1658.
21. Kim D, Brown J. Efficacy and safety of lumbar epidural dexamethasone versus methylprednisolone in the treatment of lumbar radiculopathy: A comparison of soluble versus particulate steroids. Clin J Pain 2011;27:518.
22. El-Yahchouchi C, Geske JR, Carter RE, etal. The noninferiority of the nonparticulate steroid dexamethasone vs the particulate steroids betamethasone and triamcinolone in lumbar transforaminal epidural steroid injections. Pain Med 2013;13:1650-1657.
23. Bogduk N, International Spine Intervention Society & Standards Committee. Practice Guidelines for Spinal Diagnostic and Treatment Procedures. San Francisco: International Spine Intervention Society; 2004.
24. MacVicar J, King W, Landers MH, Bogduk N. The effectiveness of lumbar transforaminal injection of steroids: A comprehensive review with systematic analysis of the published data. Pain Med 2013;14:14-28.
25. Smuck M, Fuller BJ, Chiodo A, etal. Accuracy of intermittent fluoroscopy to detect intravascular injection during transforaminal epidural injections. Spine 2008;33:E205.
26. McLean JP, Sigler JD, Plastaras CT, Garvan CW, Rittenberg JD. The rate of detection of intravascular injection in cervical transforaminal epidural steroid injections with and without digital subtraction angiography. PM R 2009;1:636-642.
27. Smuck M, Maxwell MD, Kennedy D, etal. Utility of the anesthetic test dose to avoid catastrophic injury during cervical transforaminal epidural injections. Spine J 2010;10:857-864.
28. Park JW, Nam HS, Cho SK, etal. Kambin's triangle approach of lumbar transforaminal epidural injection with spinal stenosis. Ann Rehabil Med 2012;25:833-843.
29. Smuck M, Abbott Z, Zemper E. Interpretation of contrast dispersal patterns by experienced and inexperienced interventionalists. PM R 2009;1:55-59.
30. Visco CJ, etal. Programmatic design for teaching the introductory skills and concepts of lumbar spine procedures to physiatry residents: A prospective multiyear study. Am J Phys Med Rehabil Assoc Acad Physiatr 2013;92:248-257.
31. Mannion AF, Fekete TF, O'Riordan D, etal. The assessment of complications after spine surgery: Time for a paradigm shift? Spine J 2013;13:615-624.
32. Stanczak J, Blankenbaker DG, De Smet AA, Fine J. Efficacy of epidural injections of Kenalog and Celestone in the treatment of lower back pain. AJR Am J Roentgenol 2003;181:1255-1258.
33. Blankenbaker DG, De Smet AA, Stanczak JD, Fine JP. Lumbar radiculopathy: Treatment with selective lumbar nerve blocks-Comparison of effectiveness of triamcinolone and betamethasone injectable suspensions. Radiology 2005;237:738-741.