Botulinum toxin injections for low-back pain and sciatica.

摘要: Background Adequate relief from low-back pain (LBP) is not always possible. Emerging evidence suggests a role for botulinum neurotoxin (BoNT) injections in treating disorders. Proponents of BoNT suggest its properties can decrease muscle spasms, ischemia and inflammatory markers, thereby reducing pain. Objectives To determine the effects toxin adults with LBP. Search methods We searched CENTRAL (The Cochrane Library 2009, issue 3) MEDLINE, EMBASE, CINAHL to August 2009; screened references included studies; consulted content experts Allergan. We published unpublished randomised controlled trials without language restrictions Selection criteria We that evaluated serotypes versus other treatments patients non-specific LBP any duration. Data collection analysis Two review authors selected studies, assessed risk bias using Back Review Group criteria, extracted data standardized forms. performed qualitative analysis due lack data. Main results We excluded nineteen studies non-randomisation, incomplete or data. three (N =123 patients). Only one study chronic LBP; two examined unique subpopulations. had low demonstrated reduced at eight weeks improved function better than saline injections. The second trial showed were corticosteroid plus lidocaine placebo sciatica attributed piriformis syndrome. third concluded traditional acupuncture lumbar transverse process Both high several key limitations. Heterogeneity prevented meta-analysis. There quality pain, function, both very they steroid injections. Authors' conclusions We identified investigated merits LBP, but only = 31). Further research likely have an important impact on the estimate effect our confidence it. Future should standardize patient populations, treatment protocols comparison groups, enlist more participants include long-term outcomes, cost-benefit clinical relevance findings.