Heyse-Moore G H
Acta Orthop Scand. 1978 Aug;49(4):366-70. doi: 10.3109/17453677809050089.
The results of a series of 120 epidural injections given as treatment for backache and sciatica using Methylprednisolone and local anaesthetic, performed in the Gloucestershire area, are presented and compared with other published results. Wide variations in the results of this treatment are found and these may in part be explained on the basis of the variable severity of the histological changes known to occur in and around nerve roots in cases of sciatica. The pathogenesis of sciatica in lumbar disc disease is discussed in relation to its treatment by epidural injections of a long-acting steroid. It is shown that the treatment is more successful in acute onset cases and cases that have epidurals within 6 months of the onset of symptoms and it is suggested that earlier epidurals are given in cases that do not respond to the usual conservative measures. Manipulation of the spine and sciatic stretch should not be carried out at the same time as the epidural, as these procedures may adversely affect the results in some cases and certainly tend to make them more difficult to assess.
本文呈现了在格洛斯特郡地区进行的一系列120次硬膜外注射治疗背痛和坐骨神经痛的结果，这些注射使用了甲基泼尼松龙和局部麻醉剂，并与其他已发表的结果进行了比较。发现这种治疗结果存在很大差异，部分原因可能是已知在坐骨神经痛病例中神经根及其周围发生的组织学变化严重程度不同。结合长效类固醇硬膜外注射治疗，讨论了腰椎间盘疾病中坐骨神经痛的发病机制。结果表明，该治疗在急性发病病例以及症状出现后6个月内进行硬膜外注射的病例中更为成功，并建议在对常规保守措施无反应的病例中更早进行硬膜外注射。脊柱推拿和坐骨神经拉伸不应与硬膜外注射同时进行，因为在某些情况下，这些操作可能会对结果产生不利影响，而且肯定会使结果更难以评估。
