Infiltración esteroidea epidural por vía caudal en el tratamiento del dolor lumbar crónico de origen discal. Estudio comparativo, prospectivo y aleatorizado

Cervera-Irimia, Javier; Tomé-Bermejo, Félix

doi:10.1016/j.recot.2013.05.005

Cited by 2 publications

(2 citation statements)

References 34 publications

(14 reference statements)

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“…Of the multiple trials for consideration [ 11 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ], 5 trials of lumbar fusion [ 47 , 48 , 49 , 50 , 51 ] and 2 trials of epidural injections [ 53 , 55 ] were considered for quality assessment. There were no trials available comparing total disc arthroplasty with conservative management.…”

Section: Resultsmentioning

confidence: 99%

“…Consequently, determining the appropriate strategy for managing chronic low back pain, and the disability related to it, is of utmost importance. Options range from simple exercise instructions to complex fusions [ 1 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. The rising costs of managing spinal pain have reached approximately $100 billion per year [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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What is the Role of Epidural Injections in the Treatment of Lumbar Discogenic Pain: A Systematic Review of Comparative Analysis with Fusion

et al. 2015

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BackgroundLumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery.MethodsA systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V.ResultsBased on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar.ConclusionsThe available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What is the Role of Epidural Injections in the Treatment of Lumbar Discogenic Pain: A Systematic Review of Comparative Analysis with Fusion

et al. 2015

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Non-steroidal anti-inflammatory drugs for sciatica

Rasmussen-Barr

Held

Grooten

et al. 2016

Cochrane Database of Systematic Reviews

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This updated systematic review including 10 trials evaluating the efficacy of NSAIDs versus placebo or other drugs in people with sciatica reports low- to very low-level evidence using the GRADE criteria. The efficacy of NSAIDs for pain reduction was not significant. NSAIDs showed a better global improvement compared to placebo. These findings must be interpreted with caution, as the level of evidence according to the GRADE classification was very low for the outcome pain reduction and low for global improvement due to small study samples, inconsistent results, imprecision, and a high risk of bias in the included trials. While the trials included in the analysis were not powered to detect potential rare side effects, we found an increased risk for side effects in the short-term NSAIDs use. As NSAIDs are frequently prescribed, the risk-benefit ratio of prescribing the drug needs to be considered.

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Infiltración esteroidea epidural por vía caudal en el tratamiento del dolor lumbar crónico de origen discal. Estudio comparativo, prospectivo y aleatorizado

Cited by 2 publications

References 34 publications

What is the Role of Epidural Injections in the Treatment of Lumbar Discogenic Pain: A Systematic Review of Comparative Analysis with Fusion

What is the Role of Epidural Injections in the Treatment of Lumbar Discogenic Pain: A Systematic Review of Comparative Analysis with Fusion

Non-steroidal anti-inflammatory drugs for sciatica

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