Kamble Prashant Chandrakant, Sharma Ayush, Singh Vijay, Natraj B, Devani Darshan, Khapane Vijay
King Edward Memorial Hospital Mumbai, Mumbai, India.
Department of Orthopedic, Dr B R Ambedker Central Railway Hospital, Byculla East, Mumbai, 400027, India.
Eur Spine J. 2016 Jan;25(1):217-221. doi: 10.1007/s00586-015-3996-9. Epub 2015 May 12.
To determine the efficacy of fluoroscopic guided transforaminal steroid versus interlaminar epidural steroid versus caudal steroid.
A total of 90 patients were studied who had complains of low back pain with radiculopathy and MRI evidence of disc prolapse. Out of this group, patients were randomly assigned to three groups each having 30 patients. First group received transforaminal steroid injection, second group received caudal steroid injection, and third group received epidural steroid. All patients were followed up for 12 months, and the results were compared using change in Visual Analogue Scale score and Oswestry Disability Index (OSD).
The change in pain scores was statistically different at 1- and 6-month interval such that a higher change was observed by transforaminal route as compared to the other two. There was no difference in change of scores between interlaminar and caudal routes. For OSD, a greater change was seen in transforminal at all times as compared to the other two. There was no difference in change of scores between interlaminar and caudal routes at any time of assessment.
In current study, transforaminal steroid injection group has better symptomatic improvement for both short and long term as compared to interlaminar and caudal steroid injection group.
确定透视引导下经椎间孔注射类固醇与椎板间硬膜外注射类固醇及骶管注射类固醇的疗效。
共研究90例主诉下腰痛伴神经根病且MRI有椎间盘突出证据的患者。该组患者被随机分为三组,每组30例。第一组接受经椎间孔类固醇注射,第二组接受骶管类固醇注射,第三组接受硬膜外类固醇注射。所有患者随访12个月,并使用视觉模拟评分量表得分变化和奥斯维斯特功能障碍指数(ODI)比较结果。
在1个月和6个月时疼痛评分的变化有统计学差异,经椎间孔途径观察到的变化高于其他两种途径。椎板间和骶管途径的评分变化无差异。对于ODI,与其他两种途径相比,经椎间孔途径在所有时间的变化都更大。在任何评估时间,椎板间和骶管途径的评分变化均无差异。
在本研究中,与椎板间和骶管类固醇注射组相比,经椎间孔类固醇注射组在短期和长期均有更好的症状改善。