Injections of Particulate Steroids for Nerve Root Blockade: Ultrastructural Examination of Complicating Factors

Reina, Miguel Ángel; Andrés, José Antonio De; Hernández, José María

doi:10.1007/978-3-319-09522-6_42

Cited by 2 publications

(2 citation statements)

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“…Steroid treatment is well known for controlling and alleviating pain due to its anti-inflammatory effects. 11,13,35 In 2014, The United States Food and Drug Administration (FDA) released a safety announcement and stated ‘The FDA is warning that injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis and death’. 36 However, there was judgement about the FDA safety report declaring that the FDA did not differentiate between the techniques like transforaminal, interlaminar and caudal epidural injections, nor between the different regions as cervical, thoracic and lumbar.…”

Section: Discussionmentioning

confidence: 99%

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Randomized controlled trials between dorsal root ganglion thermal radiofrequency, pulsed radiofrequency and steroids for the management of intractable metastatic back pain in thoracic vertebral body

Fanous

Saleh

Elghafar

et al. 2020

British Journal of Pain

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Background: Bone metastasis is a complication of various cancers causing severe pain. The current modalities for the treatment of metastatic axial pain include pharmacological, surgical and vertebral augmentation techniques, each of which has its own challenges. Objectives: To evaluate the effectiveness of pulsed radiofrequency (PRF), thermal radiofrequency (RF) and steroids on dorsal root ganglion (DRG) in patients with thoracic axial pain due to vertebral metastasis. Methods: In this randomized controlled prospective study, 140 patients were assessed for eligibility, of which only 69 fulfilled the criteria. Patients were randomly divided into three equal groups, PRF, RF and steroid. Results: During the assessment of pain using Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Opioid consumption using oral Morphine Equivalence (OME) and Analgesic Quantification Algorithm (AQA) – at baseline, 1 week, 1 month and 3 months – 81 patients were assessed for final eligibility, of which 12 were excluded before intervention due to drop-out. The remaining 69 were randomized (mean age: 53.87 ± 10.55, 55.78 ± 7.34 and 59.39 ± 13.72) for PRF, RF and steroid, respectively with no statistical difference. VAS% and ODI% decreased significantly at 3 months in RF group ( p <0.001, 0.014, respectively), as did the AQA ( p <0.027). Steroid group was the worst. Discussion: RF on DRG is the main stay for controlling intractable metastatic pain. PRF is a good alternative.

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Section: Discussionmentioning

confidence: 99%

“…Steroids are known to be powerful anti-inflammatory drugs; 11 most of the published randomized studies mentioned its usage either with PRF and RF on DRG 12 or alone as in epidural injections. 13 Some case reports suggested injecting steroid on DRG in case of RF and PRF failure.…”

Section: Introductionmentioning

confidence: 99%