Rahimzadeh Poupak, Imani Farnad, Farahmand Rad Reza, Faiz Seyed Hamid Reza
Department of Anesthesiology and Pain Medicine, Pain Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology and Pain Medicine, Minimally Invasive Surgery Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2024 Feb 16;14(1):e142822. doi: 10.5812/aapm-142822. eCollection 2024 Feb.
Lumbar spinal stenosis (LSS) is the most common indication for lumbar surgery in elderly patients. Epidural injections of calcitonin are effective in managing LSS.
This study aimed to compare the efficacy of transforaminal and caudal injections of calcitonin in patients with LSS.
In this double-blind randomized clinical trial, LSS patients were divided into two equal groups (N = 20). The first group received 50 IU (international units) of calcitonin via caudal epidural injection (CEI), and the second group received 50 IU of calcitonin via transforaminal epidural injection (TEI). The Visual Analogue Scale (VAS) and Oswestry Low Back Pain Disability Questionnaire (ODI) were used to assess the patient's pain and ability to stand, respectively. Visual Analogue Scale and ODI scores were recorded and analyzed.
The results showed that caudal and TEIs of calcitonin significantly improved pain and ability to stand during follow-up compared to before intervention (P < 0.05). Additionally, CEI of calcitonin after 6 months significantly reduced pain in LSS patients compared to TEI of calcitonin (P < 0.05). However, no significant difference was observed between the two epidural injection techniques in improving the patient's ability to stand (P > 0.05).
The results of the study indicate that epidural injection of calcitonin in long-term follow-up (6 months) had a significant effect on improving pain intensity and mobility in patients with LSS, and its effect on pain in the TEI method was significantly greater than that in the CEI method.
腰椎管狭窄症(LSS)是老年患者腰椎手术最常见的适应症。硬膜外注射降钙素对治疗LSS有效。
本研究旨在比较经椎间孔注射和骶管注射降钙素对LSS患者的疗效。
在这项双盲随机临床试验中,LSS患者被分为两组(每组n = 20)。第一组通过骶管硬膜外注射(CEI)接受50国际单位(IU)的降钙素,第二组通过经椎间孔硬膜外注射(TEI)接受50 IU的降钙素。分别使用视觉模拟量表(VAS)和Oswestry下腰痛残疾问卷(ODI)评估患者的疼痛程度和站立能力。记录并分析视觉模拟量表和ODI评分。
结果显示,与干预前相比,降钙素的骶管注射和TEI在随访期间显著改善了疼痛程度和站立能力(P < 0.05)。此外,与降钙素的TEI相比,6个月后降钙素的CEI显著减轻了LSS患者的疼痛(P < 0.05)。然而,在改善患者站立能力方面,两种硬膜外注射技术之间未观察到显著差异(P > 0.05)。
研究结果表明,长期随访(6个月)硬膜外注射降钙素对改善LSS患者的疼痛强度和活动能力有显著效果,且其对TEI方法疼痛的效果显著大于CEI方法。