Stout Alison
Spine and Musculoskeletal Medicine, Rehabilitation Care Services, Veterans Administration, Puget Sound, WA, USA.
Phys Med Rehabil Clin N Am. 2010 Nov;21(4):825-34. doi: 10.1016/j.pmr.2010.08.001.
Epidural steroid injection (ESI) has been used as a treatment for low back pain for over 50 years. In the last 10 to 15 years, there has been a significant increase in the use of ESIs for the treatment of low back pain and radicular pain without clear improvements in outcomes. Recent literature has focused on the use of ESIs as treatment for radicular pain associated with low back pain, with some studies showing benefit over control groups for limb symptoms. There is a lack of literature, however, to support the use of ESIs for the treatment of axial low back pain. The theoretical basis for their use, technical considerations, and the literature available for different approaches of access to the epidural space as pertaining to the treatment for low back pain without radiculopathy are reviewed.
硬膜外类固醇注射（ESI）作为治疗腰痛的方法已使用了50多年。在过去10至15年中，ESI用于治疗腰痛和神经根性疼痛的使用显著增加，但结果并未有明显改善。最近的文献聚焦于将ESI用作与腰痛相关的神经根性疼痛的治疗方法，一些研究表明在肢体症状方面比对照组更具优势。然而，缺乏文献支持将ESI用于治疗轴性腰痛。本文回顾了其使用的理论基础、技术考量以及与治疗无神经根病变的腰痛相关的不同硬膜外腔穿刺入路的现有文献。
