Sabbaghan Saeed, Mirzamohammadi Elham, Ameri Mahabadi Maryam, Nikouei Farshad, Rahbarian Farhad, Ahmadichaboki Susan, Eftekhari Samira, Zamankhani Maryam, Aghaie Aghdam Amir
Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
Occupational Medicine, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2020 Feb 29;10(1):e99764. doi: 10.5812/aapm.99764. eCollection 2020 Feb.
BACKGROUND: Epidural steroid injection is a non-operative minimally invasive procedure for pain relief in spinal canal stenosis. However, there is no significant consensus regarding its efficacy. OBJECTIVES: In this study, we aimed to evaluate the effectiveness of translaminar injection of triamcinolone in lumbar canal stenosis. METHODS: In a retrospective study, we included 111 patients with MRI-confirmed spinal canal stenosis who were irresponsive to 12 weeks of conservative treatment and underwent epidural injection of triamcinolone through the translaminar approach. Outcome measures were routinely checked before the intervention and four weeks after the intervention, which included the Visual Analog scale (VAS) for low back pain, VAS for lower-limb pain, and Oswestry Disability index (ODI). RESULTS: The study population included 32 (28.8%) males and 79 (71.2%) females with the mean age of 61 ± 13.4 years. The mean ODI, VAS for low back pain, and VAS for lower-limb pain significantly improved at the final evaluation session (P < 0.001, P = 0.001, and P < 0.001, respectively). The levels of improvement in ODI, VAS for low back pain, and VAS for lower-limb pain were considerably more in patients with single-level involvement (P < 0.001, P = 0.04, and P < 0.001, respectively). Improvement of lower-limb VAS was negatively correlated with age (r = -0.400, P < 0.001) and BMI (r = -0.525, P < 0.001). The ODI improvement was also negatively correlated with BMI (r = -0.569, P < 0.001). CONCLUSIONS: Epidural injection of triamcinolone through the translaminar approach could be regarded as an efficacious method for the alleviation of pain and disability in patients with spinal canal stenosis.
背景:硬膜外类固醇注射是一种用于缓解椎管狭窄疼痛的非手术微创方法。然而,关于其疗效尚无显著共识。 目的:在本研究中,我们旨在评估经椎板注射曲安奈德治疗腰椎管狭窄的有效性。 方法:在一项回顾性研究中,我们纳入了111例经MRI证实为椎管狭窄且对12周保守治疗无反应,并接受了经椎板途径硬膜外注射曲安奈德的患者。在干预前和干预后四周常规检查结果指标,包括腰痛视觉模拟量表(VAS)、下肢疼痛VAS和奥斯维斯特残疾指数(ODI)。 结果:研究人群包括32名(28.8%)男性和79名(71.2%)女性,平均年龄为61±13.4岁。在最终评估时,平均ODI、腰痛VAS和下肢疼痛VAS均有显著改善(分别为P<0.001、P = 0.001和P<0.001)。单节段受累患者的ODI、腰痛VAS和下肢疼痛VAS改善程度明显更高(分别为P<0.001、P = 0.04和P<0.001)。下肢VAS的改善与年龄(r = -0.400,P<0.001)和BMI(r = -0.525,P<0.001)呈负相关。ODI的改善也与BMI呈负相关(r = -0.569,P<0.001)。 结论:经椎板途径硬膜外注射曲安奈德可被视为缓解椎管狭窄患者疼痛和残疾的有效方法。
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