The preliminary results of a comparative effectiveness evaluation of adhesiolysis and caudal epidural injections in managing chronic low back pain secondary to spinal stenosis: a randomized, equivalence controlled trial.

摘要: Background Lumbar surgery and epidural injections for spinal stenosis are the most commonly performed interventions in United States. However, there is only moderate evidence to effectiveness of caudal injections. The next sequential step adhesiolysis hypertonic neurolysis with targeted delivery. There have not been any randomized trials evaluating percutaneous delivery local anesthetic, steroid sodium chloride solution lumbar stenosis. Study design A randomized, equivalence, controlled trial. Setting An interventional pain management practice, a specialty referral center, private practice setting Objectives To evaluate patients chronic low back lower extremity central compare fluoroscopically directed Methods Patients were randomly assigned one 2 groups 25 each group. Group I received catheterization up S3 0.9% solution, non-particulate betamethasone served as control II injection lidocaine, 10% Betamethasone formed intervention Randomization was by computer-generated random allocation sequence simple randomization. Outcomes assessment Multiple outcome measures utilized including Numeric Rating Scale (NRS), Oswestry Disability Index 2.0 (ODI), employment status, opioid intake at 3, 6, 12 months post treatment. Significant relief described 50% or more, whereas significant improvement disability score defined reduction 40% more. Results This evaluation showed (>or= 50%) 76% year follow-up group compared 4% Limitations results this study limited lack placebo group, fact that it preliminary report, Conclusions With patients, utilizing steroids may be effective function-limiting