دورية أكاديمية
أعرض في EDS

Combined Ultrasound and Fluoroscopy versus Ultrasound versus Fluoroscopy-Guided Caudal Epidural Steroid Injection for the Treatment of Unilateral Lower Lumbar Radicular Pain: A Retrospective Comparative Study.

التفاصيل البيبلوغرافية
العنوان: Combined Ultrasound and Fluoroscopy versus Ultrasound versus Fluoroscopy-Guided Caudal Epidural Steroid Injection for the Treatment of Unilateral Lower Lumbar Radicular Pain: A Retrospective Comparative Study.
المؤلفون: Lee DY; Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea., Park Y; Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea., Song JH; Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea., Ahn J; Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea., Cho KH; Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea., Kim S; Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea.
المصدر: Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2024 May 15; Vol. 60 (5). Date of Electronic Publication: 2024 May 15.
نوع المنشور: Journal Article; Comparative Study
اللغة: English
بيانات الدورية: Publisher: MDPI Country of Publication: Switzerland NLM ID: 9425208 Publication Model: Electronic Cited Medium: Internet ISSN: 1648-9144 (Electronic) Linking ISSN: 1010660X NLM ISO Abbreviation: Medicina (Kaunas) Subsets: MEDLINE
أسماء مطبوعة: Publication: 2018- : Basel, Switzerland : MDPI
Original Publication: Kaunas : Lietuvos gydytojų sąjunga
مواضيع طبية MeSH: Steroids*/administration & dosage , Steroids*/therapeutic use , Low Back Pain*/drug therapy, Humans ; Retrospective Studies ; Fluoroscopy/methods ; Female ; Male ; Middle Aged ; Injections, Epidural/methods ; Adult ; Aged ; Ultrasonography, Interventional/methods ; Treatment Outcome ; Radiculopathy/drug therapy ; Radiculopathy/complications ; Case-Control Studies ; Lumbar Vertebrae ; Ultrasonography/methods ; Lumbosacral Region
مستخلص: Background and Objectives : This study aimed to evaluate the mid-term effectiveness and safety of a combined ultrasound (US) and fluoroscopy (FL)-guided approach in comparison to US-guided and FL-guided caudal epidural steroid injections (CESI) for treating unilateral lower lumbar radicular pain. Materials and Methods : A total of 154 patients who underwent CESI between 2018 and 2022 were included. Patients were categorized into three groups based on the guidance method: combined US and FL (n = 51), US-guided (n = 51), and FL-guided (n = 52). The study design was retrospective case-controlled, utilizing patient charts and standardized forms to assess clinical outcomes, adverse events, complications during the procedures. Results : In all groups, Oswestry Disability Index and Verbal Numeric Scale scores improved at 1, 3, and 6 months after the last injection, with no significant differences between groups ( p < 0.05). The treatment success rate at all time points was also similar among the groups. Logistic regression analysis showed that injection method, cause, sex, age, number of injections, and pain duration did not independently predict treatment success. Blood was aspirated before injection in 2% (n = 1), 13.5% (n = 7), and 4% (n = 2) of patients in the combined US and FL groups, FL-guided groups, and US-guided groups, respectively. Intravascular contrast spread was detected in one patient in the combined method groups and seven in the FL-guided groups. Conclusions : When comparing pain reduction and functional improvement, there was no significant difference between the three methods. The combined method took less time compared to using FL alone. The combined approach also showed a lower occurrence of intravascular injection compared to using FL alone. Moreover, blood vessels at the injection site can be identified with an ultrasound using the combined method. Given these advantages, it might be advisable to prioritize the combined US- and FL-guided therapy when administering CESI for patients with unilateral lumbar radicular pain.
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فهرسة مساهمة: Keywords: caudal; epidural; fluoroscopy; injections; radiculopathy; ultrasound
المشرفين على المادة: 0 (Steroids)
تواريخ الأحداث: Date Created: 20240525 Date Completed: 20240525 Latest Revision: 20240527
رمز التحديث: 20240527
مُعرف محوري في PubMed: PMC11123251
DOI: 10.3390/medicina60050809
PMID: 38792992
قاعدة البيانات: MEDLINE
الوصف
تدمد:1648-9144
DOI:10.3390/medicina60050809