Sciatica: Treatment With Epidural Injections of Procaine and Hydrocortisone

Hw, Goebert; Sj, Jallo; Wj, Gardner; Ce, Wasmuth; Em, Bitte

doi:10.3949/ccjm.27.4.191

Cited by 46 publications

(17 citation statements)

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“…The aetiology of pain was usually undefined and there were neither therapeutic controls nor structured follow up. Goebert et al 20 21 reported relief of radicular pain in 72% of 352 patients with sciatica treated with 30 ml volumes of 1% procaine hydrochloride and 125 mg hydrocortisone by caudal epidural injection adjacent to the involved nerve root. They used no controls and outcome was not defined past 12 weeks.…”

Section: Efficacy Of Intraspinal Therapymentioning

confidence: 99%

Intraspinal steroids: history, efficacy, accidentality, and controversy with review of United States Food and Drug Administration reports

Nelson

2001

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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Section: Efficacy Of Intraspinal Therapymentioning

confidence: 99%

Intraspinal steroids: history, efficacy, accidentality, and controversy with review of United States Food and Drug Administration reports

Nelson

2001

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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“…Of these 8 had a very good response, 15 good and 8 mediocre. Goebert et al [22] were the first to report the use of epidural corticosteroids against sciatica in the United States: 3 injections of procaine and hydrocortisone caused greater than 60% relief of symptoms in 58% of patients (n = 239).…”

Section: Compound E and The Quest For Evidencementioning

confidence: 99%

“…A variety of anesthetics (procaine, lidocaine, bupivacaine) as well as a number of glucocorticoids (hydrocortisone, methylprednisolone, triamcinolone) have been used. The caudal approach, originally described by 20 Retrospective 100 at 52 weeks Goebert, 1960 239 Retrospective 6 at 12-130 weeks Gardner, 1961 113 Retrospective 83 at >12 weeks Winnie, 1972 10 Prospective 100 at 2-104 weeks Rosen, 1988 40 Sicard and Cathelin, has largely been replaced by interlaminar and transforaminal injections that are usually given under fluoroscopic guidance. With the interlaminar approach, the needle is placed in the posterior epidural space comparable to epidural catheter placement in surgery.…”

Section: Current State Of the Artmentioning

confidence: 99%

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The Epidural Treatment of Sciatica: Its Origin and Evolution

et al. 2016

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Epidural injection with corticosteroids is a common treatment option for patients with lower back pain or sciatica. In this paper we review its origin and evolution. The first injections were given around 1900 in Paris by Jean Sicard (1872-1929) and Fernand Cathelin (1873-1945), who worked independently. They both injected small volumes of cocaine into the sacral hiatus. After a slow start, the epidural treatment of back pain and sciatica gradually spread to other parts of Europe and Northern America. In the early 1950s, corticosteroids were introduced for epidural use. Since the 1970s, there have been numerous clinical trials that show a significant, although small, effect of epidural corticosteroid injections compared with placebo for leg pain in the short term. Despite an ongoing debate about effectiveness and safety, epidural injections remain popular.

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“…Epidural steroid injection (ESI) was first performed in the 1950s, it evolved as a therapeutic option during the 1960s, and it became a cornerstone in the management of low back pain and sciatica in the 1970s (2)(3)(4)(5)(6). During these decades, needle placement and injection site depended on palpated landmarks and loss-of-resistance techniques.…”

Section: Essentialsmentioning

confidence: 99%

Spinal Injections for Pain Management

Palmer

2016

Radiology

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Image-guided spinal injection is commonly performed in symptomatic patients to decrease pain severity, confirm the pain generator, and delay or avoid surgery. This article focuses on the radiologist as spine interventionist and addresses the following four topics relevant to the radiologist who performs corticosteroid injections for pain management: (a) the rationale behind corticosteroid injection, (b) the interaction with patients, (c) the role of imaging in procedural selection and planning, and (d) the pearls and pitfalls of fluoroscopically guided injections. Factors that contribute to the success of a pain management service include communication skills and risk mitigation. A critical factor is the correlation of clinical symptoms with magnetic resonance (MR) imaging findings. Radiologists can leverage their training in MR image interpretation to distinguish active pain generators in the spine from incidental abnormalities. Knowledge of fluoroscopic anatomy and patterns of contrast material flow guide the planning and execution of safe and effective needle placement.q RSNA, 2016

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Sciatica: Treatment With Epidural Injections of Procaine and Hydrocortisone

Cited by 46 publications

References 0 publications

Intraspinal steroids: history, efficacy, accidentality, and controversy with review of United States Food and Drug Administration reports

Intraspinal steroids: history, efficacy, accidentality, and controversy with review of United States Food and Drug Administration reports

The Epidural Treatment of Sciatica: Its Origin and Evolution

Spinal Injections for Pain Management

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