Format

Send to

Choose Destination
See comment in PubMed Commons below
Spine (Phila Pa 1976). 2001 May 1;26(9):1059-67.

Periradicular infiltration for sciatica: a randomized controlled trial.

Author information

1
Department of Physical Medicine and Rehabilitation, University Hospital of Oulu, Finland. jaro.karppinen@ppshp.fi

Abstract

STUDY DESIGN:

A randomized, double-blind trial was conducted.

OBJECTIVES:

To test the efficacy of periradicular corticosteroid injection for sciatica.

SUMMARY OF BACKGROUND DATA:

The efficacy of epidural corticosteroids for sciatica is controversial. Periradicular infiltration is a targeted technique, but there are no randomized controlled trials of its efficacy.

METHODS:

In this study 160 consecutive, eligible patients with sciatica who had unilateral symptoms of 1 to 6 months duration, and who never underwent surgery were randomized for double-blind injection with methylprednisolone bupivacaine combination or saline. Objective and self-reported outcome parameters and costs were recorded at baseline, at 2 and 4 weeks, at 3 and 6 months, and at 1 year.

RESULTS:

Recovery was better in the steroid group at 2 weeks for leg pain (P = 0.02), straight leg raising (P = 0.03), lumbar flexion (P = 0.05), and patient satisfaction (P = 0.03). Back pain was significantly lower in the saline group at 3 and 6 months (P = 0.03 and 0.002, respectively), and leg pain at 6 months (13.5, P = 0.02). Sick leaves and medical costs were similar for both treatments, except for cost of therapy visits and drugs at 4 weeks, which were in favor of the steroid injection (P = 0.05 and 0.005, respectively). By 1 year, 18 patients in the steroid group and 15 in the saline group underwent surgery.

CONCLUSIONS:

Improvement during the follow-up period was found in both the methylprednisolone and saline groups. The combination of methylprednisolone and bupivacaine seems to have a short-term effect, but at 3 and 6 months, the steroid group seems to experience a "rebound" phenomenon.

PMID:
11337625
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins
    Loading ...
    Support Center