Epidural steroid block in herniated disc: A systematic review

Túlio César Azevedo Alves, Ana Claudia Oliveira Costa, Alba Benemérita Alves Vilela

Article ID: 62
Vol 1, Issue 1, 2017

VIEWS - 550 (Abstract) 471 (PDF)

Abstract


Back pain secondary to herniated disc is very common throughout the world, leading to frequent absence from work activities, economic and financial losses, in addition to causing major affective-motivational changes. Initial treatment is based on analgesic and anti-inflammatory therapy. However, in most cases, it evolves chronically and requires surgery or minimally invasive procedures like epidural steroid injections. This paper proposes, through a systematic literature review, to establish the effectiveness of epidural steroid for the treatment of lumbar disc herniation. We selected 7 papers, of which 5 showed effectiveness of the technique above 56%. The papers showed an important reduction in pain intensity and indication of surgery, besides safety and tolerability.

Keywords


Intervertebral disc displacement; anesthesia; epidural; adrenal cortex hormones

Full Text:

PDF


References


1. Stafford MA, Peng P, Hill DA. Sciatica: A review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth 2007; 99(4): 461–473. doi: 10.1093/bja/aem238

2. Manson NA, McKeon MD, Abraham EP. Transforaminal epidural steroid injections prevent the need for surgery in patients with sciatica secondary to lumbar disc herniation: A retrospective case series. Can J Surg 2013; 56(2): 89–96. doi: 10.1503/cjs.014611

3. Collighan N, Gupta S. Epidural steroids. Contin Educ Anaesthe Crit Care Pain 2010; 10(1): 1–5. doi: 10.1093/bjaceaccp/mkp043

4. Vad VB, Bhat AL, Lutz GE, et al. Transforaminal epidural steroid injections in lumbosacral radiculopathy: A prospective randomized study. Spine 2002; 27(1): 11–16. doi: 10.1097/00007632-200201010-00005

5. Krych AJ, Richman D, Drakos M, et al. Epidural steroid injection for lumbar disc herniation in NFL athletes. Med Sci Sports Exerc 2012; 44(2): 193–198. doi: 10.1249/MSS.0b013e31822d7599

6. Baral BK, Shrestha RR, Shrestha AB, et al. Effectiveness of epidural steroid injection for the management of symptomatic herniated lumbar disc. Nepal Med Coll J 2011; 13(4): 303–307.

7. Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: A proposal for reporting. JAMA 2000; 283(15): 2008–2012. doi: 10.1001/jama.283.15.2008

8. Schaufele MK, Hatch L, Jones W. Interlaminar versus transforaminal epidural injections for the treatment of symptomatic lumbar intervertebral disc herniations. Pain Physician 2006; 9(4): 361–366.

9. Ursi ES, Gavão CM. Perioperative prevention of skin injury: An integrative literature review. Rev Latino-Am Enferm 2006; 14(1): 124–131. doi: 10.1590/S0104-11692006000100017

10. Jadad AR, Moore RA, Carroll D, et al. Assessing the quaility of reports of randomized clinical trials: Is blinding necessary? Controlled Clin Trials 1996; 17(1): 1–12. doi: 10.1016/0197-2456(95)00134-4

11. Buttermann GR. Treatment of lumbar disc herniation: Epidural steroid injection compared with discectomy. A prospective, randomized study. J Bone Joint Surg Am 2004; 86(4): 670–679. doi: 10.2106/00004623-200404000-00002

12. Radcliff K, Hilibrand A, Lurie JD, et al. The impact of epidural steroid injections on the outcomes of patients treated for lumbar disc herniation. J Bone Joint Surg Am 2012; 94(5): 1353–1358. doi: 10.2106/JBJS.K.00341

13. Gerszten PC, Smuck M, Rathmell JP, et al. Plasma disc decompression compared with fluoroscopy-guided transforaminal epidural steroid injections for symptomatic contained lumbar disc herniation: A prospective, randomized, controlled trial. J Neurosurg Spine 2010; 12(4): 357–371. doi: 10.3171/2009.10.SPINE09208




DOI: https://doi.org/10.63018/nc.v1i1.62

Refbacks

  • There are currently no refbacks.


Copyright (c) 2017 Túlio César Azevedo Alves

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.