Clinical Comparison of Effectiveness of Epidural Triamcinolone and Betamethasone in Discal Radiculalgia: A Prospective, Randomized Study

Çöçelli, Lütfiye Pirbudak; Karakurum, Gunhan; Cebesoy, Oğuz; Karadaşlı, Hakan; Öner, Ünsal

doi:10.1080/10582450903088070

Cited by 7 publications

(9 citation statements)

References 15 publications

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“…Description of epidural/intradiscal injection studies Summary of interventions Sixty-three studies evaluated the use of epidural/intradiscal injection for sciatica 95, (eight studies had more than two treatment arms 146,149,161,163,167,169,183,197 181,[183][184][185]187,193,194,197,200,202 (two studies had more than two treatment arms 183,197 ) compared different modes of administering epidural/intradiscal injections and 20 studies 149,167,[177][178][179][180]182,186,[188][189][190][191][192]195,196,198,199,203,204,207 compared the use of different epidural/intradiscal injections. Details of the interventions are summarised in Table 17b, but the findings of these studies are not considered any further here.…”

Section: Epidural/intradiscal Injectionmentioning

confidence: 99%

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Lewis

Williams²,

Matar³

et al. 2011

Health Technol Assess

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAThe clinical effectiveness and costeffectiveness of management strategies for sciatica: systematic review and economic model NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA pro...

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Section: Epidural/intradiscal Injectionmentioning

confidence: 99%

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Lewis

Williams²,

Matar³

et al. 2011

Health Technol Assess

View full text Add to dashboard Cite

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“…Fig. 1 presents a flowchart of the selection process, and the results are summarized in Table 2 [ 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…One RCT and one SR with high-quality evidence showed that cervical interlaminar epidural injections of local anesthetics with or without steroids may be effective but presented evidence that steroids were not superior to local anesthetics alone [ 21 22 ]. One trial found no significant difference between betamethasone and triamcinolone in reducing radicular pain in the lumbar spine, but both steroids resulted in significant improvement in the reduction of radicular pain in the short term (within 6 weeks) [ 23 ]. One trial found no significant difference between fluoroscopy-guided and ultrasound-guided lumbar interlaminar epidural injections [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…Several reviews concluded that the use of steroids in epidural injections showed no benefit over the use of local anesthetics alone [ 16 17 20 ], although one RCT demonstrated that their use in epidural injections could have potential benefits pertaining to lumbar sciatica [ 20 ]. Regarding which steroids are better in epidural injections, the searched studies found no differences for cervical and lumbar radiculopathy [ 18 23 ], but in 2014, the U.S. Food and Drug Administration warned of rare but serious neurologic problems after epidural corticosteroid injections for pain and especially the use of particle steroids. Radiofrequency treatment showed no superiority over placebo, but higher efficacy was achieved when it was used in conjunction with block procedures compared with that when block procedures were used alone [ 14 23 ]; however, more evidence seems to be needed.…”

Section: Discussionmentioning

confidence: 99%

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Neuropathic Pain Related with Spinal Disorders: A Systematic Review

et al. 2017

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Systematic literature review. To review the evidence from high-quality studies regarding the treatment of neuropathic pain originating specifically from spinal disorders. In general, treatment guidelines for neuropathic pain cover all its various causes, including medical disease, peripheral neuropathy, and cancer. However, the natural history of neuropathic pain originating from spinal disorders may differ from that of the pain originating from other causes or lesions. An expert research librarian used terms related to neuropathic pain and spinal disorders, disc herniation, stenosis, and spinal cord injury to search in MEDLINE, Embase, and Cochrane CENTRAL for primary research from January 2000 to October 2015. Among 2,313 potential studies of interest, 25 randomized controlled trials (RCTs) and 21 systematic reviews (SRs) were included in the analysis. The selection was decided based on the agreement of two orthopedic surgeons. There was a lack of evidence about medication for radiculopathy arising from disc herniation and stenosis, but intervention procedures, including epidural block, showed positive efficacy in radiculopathy and also limited efficacy in spinal stenosis. There was some evidence based on the short-term follow-up regarding surgery being superior to conservative treatments for radiculopathy and stenosis. There was limited evidence regarding the efficacy of pharmacological and electric or magnetic stimulation therapies for neuropathic pain after spinal cord injury. This review of RCTs and SRs with high-quality evidence found some evidence regarding the efficacy of various treatment modalities for neuropathic pain related specifically to spinal disorders. However, there is a need for much more supportive evidence.

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“…The injection dose was adjusted to 4 mL from a triamcinolone acetonide (80 mg, Kenacort ampule, Bristol-Myers Squibb) and 0.25% bupivacaine (10 mg) mixture. Triamcinolone was preferred to betamethasone because of its fast analgesic activity and its effectiveness for ESIs due to its short-term advantages (15). Once it was confirmed that the needle was not in the subarachnoid space, 4 mL of the prepared mixture was injected.…”

Section: Methodsmentioning

confidence: 99%

The effect of tramadol and tramadol + gabapentin combination in patients with lumbar disc herniation after epidural steroid injection

Pirbudak¹,

Çiçek²,

Işık³

et al. 2015

Turk J Med Sci

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Background/aim: To compare the effects of tramadol-only treatment and tramadol + gabapentin treatment in patients who had received an epidural steroid injection. Materials and methods:Forty patients with hernia disc-originated acute lumbar discogenic pain were evaluated. All patients received a single dose of steroid and local anesthesia mixture epidurally via the lumbar approach. In both groups, Group T (tramadol, n = 20) and Group TG (tramadol + gabapentin, n = 20), the injection dose was adjusted to 4 mL of triamcinolone acetonide and 0.25% bupivacaine mixture. Orally, 75 mg/day tramadol or 75 mg/day tramadol + 900 mg/day gabapentin were added to the treatment. Leukocyte, erythrocyte sedimentation rate, C-reactive protein, and urine serotonin levels were measured prior to and after treatment. The effectiveness of the treatment was evaluated by visual analog scale (VAS), Oswestry Disability Index (ODI), and straight leg elevation test (SLET).Results: Similar improvements in VAS, ODI, and SLET values were observed in both groups in the second week. The inflammation markers were not different after treatment, neither within the groups nor between the groups. Conclusion:This study revealed that tramadol + gabapentin treatment was not superior to tramadol treatment.

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Clinical Comparison of Effectiveness of Epidural Triamcinolone and Betamethasone in Discal Radiculalgia: A Prospective, Randomized Study

Cited by 7 publications

References 15 publications

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Neuropathic Pain Related with Spinal Disorders: A Systematic Review

The effect of tramadol and tramadol + gabapentin combination in patients with lumbar disc herniation after epidural steroid injection

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