Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY 10021, USA.
Med Sci Sports Exerc. 2012 Feb;44(2):193-8. doi: 10.1249/MSS.0b013e31822d7599.
To our knowledge, there is no published information on the efficacy of epidural steroid injections for the treatment of lumbar disc herniation in an athletic population. The purpose of this study was to evaluate the efficacy of epidural corticosteroid injection for treatment of lumbar disc herniation in a group of National Football League (NFL) players.
We retrospectively reviewed the records of all NFL players who underwent an epidural steroid injection at our institution for incapacitating pain secondary to an acute lumbar disc herniation (confirmed on magnetic resonance imaging) from 2003 to 2010. Our primary outcome was success of the injection, defined as return to play. The secondary outcome of the study was to evaluate risk factors for failure of this treatment approach.
Seventeen players had a total of 37 injections for 27 distinct lumbar disc herniation episodes from 2003 to 2010. The success rate of returning an athlete to play for a given episode of disc herniation was 89% (24 of 27 episodes) with an average loss of 2.8 practices (range = 0-12) and 0.6 games (range = 0-2) after the injection. Four players required a repeat injection for the same episode. Three of these four players ultimately failed conservative management and required surgical intervention. Risk factors for failing injection therapy included sequestration of the disc herniation on magnetic resonance imaging (P = 0.01) and weakness on physical examination (P = 0.002). There were no complications reported.
In this highly selective group of professional athletes, our results suggest that epidural steroid injections are a safe and effective therapeutic option in the treatment of symptomatic lumbar disc herniation.
据我们所知，目前尚无关于硬膜外类固醇注射治疗运动人群腰椎间盘突出症疗效的文献报道。本研究旨在评估硬膜外皮质类固醇注射治疗国家橄榄球联盟（NFL）运动员腰椎间盘突出症的疗效。
我们回顾性分析了 2003 年至 2010 年期间，因急性腰椎间盘突出症（磁共振成像证实）导致无法活动的疼痛而在我院接受硬膜外类固醇注射治疗的所有 NFL 运动员的记录。我们的主要结局是注射的成功，定义为重返赛场。本研究的次要结局是评估这种治疗方法失败的风险因素。
2003 年至 2010 年，17 名运动员因 27 次不同的腰椎间盘突出症发作共接受了 37 次注射。对于特定的椎间盘突出症发作，使运动员重返赛场的成功率为 89%（27 例中的 24 例），平均损失 2.8 次练习（范围=0-12）和 0.6 场比赛（范围=0-2）。4 名运动员因同一发作需要重复注射。这 4 名患者中有 3 名最终保守治疗失败，需要手术干预。注射治疗失败的风险因素包括磁共振成像上椎间盘突出症的隔离（P=0.01）和体格检查上的无力（P=0.002）。未报告并发症。
在这组高度选择的职业运动员中，我们的结果表明，硬膜外类固醇注射是治疗有症状的腰椎间盘突出症的一种安全有效的治疗选择。
