Abstract:
BACKGROUND:Epidural steroid injections are commonly used for chronic spinal pain. However, there is no conclusive evidence regarding their effectiveness, and debate continues as to their value in managing chronic spinal pain. OBJECTIVE:To evaluate various types of epidural injections (interlaminar, transforaminal, and caudal) for managing chronic spinal pain (axial and radicular). STUDY DESIGN:A systematic review utilizing the criteria established by the Agency for Healthcare Research and Quality (AHRQ) for evaluation of randomized and non-randomized trials, and criteria of the Cochrane Musculoskeletal Review Group for randomized trials. METHODS:Data sources included relevant English literature identified through searches of MEDLINE and EMBASE (January 1966 to November 2004), manual searches of bibliographies of known primary and review articles and abstracts from scientific meetings within the last 2 years. Three reviewers independently assessed the trials for the quality of their methods. Subgroup analyses were performed for trials with different control groups, with different modes of epidurals (interlaminar, transforaminal, and caudal), with different injection sites (cervical/thoracic, lumbar/sacral), and with timing of outcome measurement (short- and long-term). OUTCOME MEASURES:The primary outcome measure was pain relief. Other outcome measures were functional improvement, improvement of psychological status, and return to work. Short-term improvement was defined as less than 6 weeks, and long-term improvement was defined as 6 weeks or longer. RESULTS:For lumbar radicular pain with interlaminar lumbar epidural steroid injections, the level of evidence was strong for short-term relief and limited for long-term relief. For cervical radicular pain with cervical interlaminar epidural steroid injections, the evidence was moderate. The evidence for lumbar transforaminal epidural steroid injections for lumbar nerve root pain was strong for short-term and moderate for long term improvement. The evidence for cervical transforaminal epidural steroid injections for cervical nerve root pain was moderate. The evidence was limited for lumbar radicular pain in post lumbar laminectomy syndrome. The evidence for caudal epidural steroid injections was strong for short-term relief and moderate for long-term relief. For managing chronic postlumbar laminectomy syndrome and spinal stenosis the evidence was limited for low back and radicular pain. The evidence was moderate for chronic low back pain. CONCLUSION:The evidence for effectiveness of epidural injections in managing chronic spinal pain ranged from limited to strong.
journal_name
Pain Physicianjournal_title
Pain physicianauthors
Abdi S,Datta S,Lucas LFsubject
Has Abstractpub_date
2005-01-01 00:00:00pages
127-43issue
1eissn
1533-3159issn
2150-1149journal_volume
8pub_type
杂志文章相关文献
Pain Physician文献大全abstract:BACKGROUND:Infraorbital neuralgia, one of the rare causes of facial pain, lacks systematic treatment guidelines because few studies on the topic have been published. We previously found that 42°C percutaneous nondestructive pulsed radiofrequency (PRF) treatment could achieve satisfactory pain relief for infraorbital ne...
journal_title:Pain physician
pub_type: 临床试验,杂志文章
doi:
更新日期:2019-05-01 00:00:00
abstract::Strategy formation involves understanding the environment and strengths and weaknesses of a practice to develop a game plan to achieve goals. It starts with the creation of a mission statement that defines a long-term vision of what the practice seeks to be and the markets it seeks to serve. Once the mission of the pr...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Bone cement leakage in patients with vertebral fracture limits the use of percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP). Finding a method to reduce bone cement leakage is clinically rather important. OBJECTIVE:To compare the efficacy and safety of bone-filling mesh containers (BFMCS) ...
journal_title:Pain physician
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Onabotulinumtoxin-A (BoNT-A) is effective for the treatment of interstitial cystitis/painful bladder syndrome (IC/PBS). However, long-term follow-up does not show successful outcome after a single injection. OBJECTIVES:To evaluate the efficacy and safety of repeated intravesical BoNT-A injections for treatm...
journal_title:Pain physician
pub_type: 临床试验,杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Suprascapular nerve block is performed in the management of chronic shoulder pain and frozen shoulder. OBJECTIVE:To investigate the effects of ultrasound-guided suprascapular nerve block in restoration of shoulder motion in breast cancer survivors. STUDY DESIGN:A cohort study. SETTING:A training and resea...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Throughout the COVID-19 pandemic, clinicians have had to think quickly, adapt to changing recommendations sometimes on a daily basis, and have often had to rely on trial-and-error-based treatment protocols under various conditions. As we move on past the apex of the COVID-19 curve, new treatment protocols fo...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Cervicogenic headache descriptors include its unilateral nature, "signs and symptoms linking it to the neck," and trauma of the neck. Since the pain often occurs over the C2 or C3 nerve root, we used a modification of the deep cervical block technique for treatment of this refractory type headache. OBJECTIV...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:The spine, pelvis, skull, and femur are the most common sites of bone metastases, and pain is the main symptom of metastatic tumors. Percutaneous femoroplasty (PFP) is becoming increasingly popular for treating proximal femoral metastases. OBJECTIVES:To assess the clinical value and feasibility of PFP perfo...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Postherpetic neuralgia (PHN) is often refractory to existing treatments. Pulsed radiofrequency (PRF) is known to be effective for treating neuropathic pain. In common, the targets of PRF treatment were the segmental dorsal root ganglion (DRG) neurons responsible for the pain. A potential complication that ca...
journal_title:Pain physician
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Pain medicine practices vary across different regions within a country and between countries. OBJECTIVES:The objective of the survey was to study the variation in interventional pain medicine practices in the United Kingdom (UK) and the United States (US). METHODS:A survey was designed in 2019 on Survey Mo...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Interventional pain physicians commonly encounter patients with a treatment refractory "chronic pain syndrome". Such patients have a chronically painful medical disorder that is complicated by a number of psychosocial factors, including psychiatric and substance use disorders, physical deconditioning, depend...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Understanding the mechanisms of long-standing musculoskeletal pain and adaptations in response to physical rehabilitation is important for developing optimal treatment strategies. The influence of central adaptations of pain perception in response to rehabilitation of musculoskeletal pain remains unclear. O...
journal_title:Pain physician
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2012-09-01 00:00:00
abstract::This report describes a 39 year-old woman who underwent attempted discography and intradiscal electrothermal therapy (IDET) of the L5/S1 intervertebral disc. The procedure was abandoned after multiple unsuccessful attempts to cannulate the disc. The case was complicated by at least two lumbar dural punctures, confirme...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Until now, few studies had investigated the neuropathic pain component in patients with a rotator cuff tear (RCT). OBJECTIVES:The aim of the study was to identify the neuropathic pain component in patients with RCT and to determine the factors correlated with neuropathic pain in patients with RCT. STUDY DE...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Discography has been widely used in the lumbar and cervical spine as a diagnostic tool to identify sources of discogenic pain that may be amenable to surgical treatment. Discography in the cervical spine is currently performed without the benefit of pressure monitoring, and corresponding pressure parameters ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Abuse of prescribed controlled substance has become a serious social as well as health care issue over the past decade. A particularly alarming trend exists among patients aged 12 to 17. Common abuse behaviors include doctor shopping, drug theft, feigned pain symptoms to gain health care access, drug sharing...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Several meta-analyses have been performed to compare unilateral percutaneous kyphoplasty (PKP) and bilateral PKP in the treatment of osteoporotic vertebral compression fractures (OVCFs), but inconsistencies in the results have led to questions as to which technique is preferable. OBJECTIVE:This study was de...
journal_title:Pain physician
pub_type: 杂志文章,meta分析
doi:
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Neuropathic pain (NP) is a major public health problem worldwide. Because of the unclear mechanism of NP, its treatment is one of the most difficult medical problems. As a targeted, noninvasive, safe therapy, pulsed radiofrequency (PRF) provides a new method for the treatment of NP; however, its effect on th...
journal_title:Pain physician
pub_type: 杂志文章,meta分析
doi:
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:The rapid increase in the prevalence of chronic pain and disability, and the explosion of interventional pain management associated health care costs are a major concern for our community. Further, the increasing utilization of numerous modalities of treatments in managing chronic pain, continue to escalate ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2015-03-01 00:00:00
abstract::Appropriate documentation, billing and coding in interventional pain practice is a crucial issue with a wide arena of regulatory reforms. There have been reports of billions of dollars in losses in health care fraud. Office of Inspector General reports a massive war on health fraud. Substantial savings from prepayment...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Symptomatic lumbar spinal stenosis (LSS) patients often suffer from multiple etiologies, and patient symptoms must be differentiated and identified as either neurogenic claudication, radicular pain, or both. The most common symptom associated with LSS is neurogenic claudication, which has been reported to oc...
journal_title:Pain physician
pub_type: 临床试验,杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:The central analgesic tapentadol prolonged release (PR) has proven effective and generally well tolerated in a broad range of chronic pain conditions. Long-term data of its use are still scarce. OBJECTIVES:To evaluate long-term effectiveness, tolerability, and safety of tapentadol PR in patients with severe...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Latent varicella zoster virus reactivates mainly in sensory ganglia such as the dorsal root ganglion (DRG) or trigeminal ganglion. The DRG contains many receptor channels and is an important region for pain signal transduction. Sustained abnormal electrical activity to the spinal cord via the DRG in acute he...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Therapeutic lumbar facet joint interventions are implemented to provide long-term pain relief after the facet joint has been identified as the basis for low back pain. The therapeutic lumbar facet joint interventions generally used for the treatment of low back pain of facet joint origin are intraarticular f...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Over the last decade various guidelines for quality assurance in pain medicine have been published for cancer pain, acute postoperative pain and other pain conditions. However, quality assurance for interventional pain management procedures has yet to be addressed. An interventional pain program should at le...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2006-04-01 00:00:00
abstract::Vertebroplasty and kyphoplasty are relatively new techniques used to treat painful vertebral compression fractures (VCFs). Vertebroplasty is the injection of a vertebral body with bone cement, generally polymethylmethacrylate (PMMA). Kyphoplasty is the placement of balloons (called "tamps") into the vertebral body wit...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract::The increasing use of opioids to manage pain in the United States over the last decade has resulted in a subset of our population developing opioid tolerance. While the management of opioid tolerant patients during acute episodes of care is well known to be a challenge amongst health care providers, there is little in...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2014-07-01 00:00:00
abstract::Appropriate diagnosis is essential in providing proper and effective therapy. The field of diagnostic accuracy tests is dynamic with new tests being developed at a fast pace along with improvement in technology of existing tests on a continuous basis. Well-designed diagnostic test accuracy studies can help in making a...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Symptomatic lumbar spinal stenosis is a condition affecting a growing number of individuals resulting in significant disability and pain, leading to a multitude of interventions ranging from simple over the counter medication to opioids, and, finally, to complex surgical fusions. After failure of conservativ...
journal_title:Pain physician
pub_type: 杂志文章,meta分析
doi:
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Elderly patients in general exhibit a higher incidence of chronic and neuropathic pain conditions. This group poses a particular clinical challenge due to age-related pharmacokinetic and pharmacodynamic issues, comorbid conditions, and polypharmacy, as well as frailty and cognitive decline. Poor control of p...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2015-09-01 00:00:00