umbar spinal canal stenosis is the narrowing or stricture of the spinal canal, with possible subsequent nerve impingement (1). The canal components that contribute to its narrowing include facet joint hypertrophy, ligamentum flavum thickening, bone spurs, and multilevel disc bulge or protrusion (2).
Lumbar spinal canal stenosis is one of the most
Pain Physician: March/April 2016: 19:139-146
140 www.painphysicianjournal.com sion), and patients with a history of adverse reaction to either local anesthetics, steroids, or calcitonin.
An intravenous catheter (20 G) was inserted in a peripheral line for crystalloid infusion and sedation.
Patients were given intravenous midazolam 0.05 mg/ kg before the procedure. Basic monitoring with noninvasive …show more content…
The patients were randomly assigned into 2 groups.
Group I, called the steroid group, received 2 sets of epidural injections one week apart, each injection contained 40 mg methylprednisolone (Depomedrol) with 8 mL lidocaine 0.5% under c-arm at the site of stenosis. Group II, called the calcitonin group, received
2 sets of epidural injections one week apart composed of 40 mg methylprednisolone (Depomedrol) added to
8 mL of 0.5% lidocaine plus 50 international units (IU) of calcitonin.
The patient was put in a prone position with a pillow under the pelvis to flatten the lumbosacral curve.
The lumbosacral area was sterilized with bovine iodine and draped. The procedure was performed under fluoroscopy and the injectate was put at the level of maximum stenosis. The epidural needle pathway was anesthetized with 3 mL lidocaine 1%. Under anteroposterior view, an 18 gauge epidural needle was introduced.
The epidural space was identified by the loss of resistance technique for saline and confirmed radiologically by the characteristic longitudinal spread of dye
(2 mL of Omipaque 300 mg/mL) in the epidural space.
Study …show more content…
The randomization was performed using sealed envelopes indicating the group of the assignment at the time of the first visit to the pain clinic by a chief nurse, who read the number contained in the envelope and determined group assignments, but did not participate in patients’ follow-up.
Measurements
The assessment times were pre-enrollment and second week, first, second, fourth, sixth, eighth, tenth, and twelfth month and the following were recorded:
1. Pain on movement was evaluated by VAS 0 – 10
(where 0 means no pain and 10 means the worst common causes of spine pain and disability. The difficulty in diagnosis lies in the absence of clinical symptoms at rest, with pain and limitation of mobility described under physical strain (3,4).
Even though many studies demonstrated that surgery has better long-term results, a large number of people improved with nonsurgical intervention. Moreover, surgery is associated with high rates of complications relative to nonsurgical intervention (5). Epidural steroid injection has been increasingly employed for pain management in such patients who refuse
Lumbar spinal canal stenosis is one of the most
Pain Physician: March/April 2016: 19:139-146
140 www.painphysicianjournal.com sion), and patients with a history of adverse reaction to either local anesthetics, steroids, or calcitonin.
An intravenous catheter (20 G) was inserted in a peripheral line for crystalloid infusion and sedation.
Patients were given intravenous midazolam 0.05 mg/ kg before the procedure. Basic monitoring with noninvasive …show more content…
The patients were randomly assigned into 2 groups.
Group I, called the steroid group, received 2 sets of epidural injections one week apart, each injection contained 40 mg methylprednisolone (Depomedrol) with 8 mL lidocaine 0.5% under c-arm at the site of stenosis. Group II, called the calcitonin group, received
2 sets of epidural injections one week apart composed of 40 mg methylprednisolone (Depomedrol) added to
8 mL of 0.5% lidocaine plus 50 international units (IU) of calcitonin.
The patient was put in a prone position with a pillow under the pelvis to flatten the lumbosacral curve.
The lumbosacral area was sterilized with bovine iodine and draped. The procedure was performed under fluoroscopy and the injectate was put at the level of maximum stenosis. The epidural needle pathway was anesthetized with 3 mL lidocaine 1%. Under anteroposterior view, an 18 gauge epidural needle was introduced.
The epidural space was identified by the loss of resistance technique for saline and confirmed radiologically by the characteristic longitudinal spread of dye
(2 mL of Omipaque 300 mg/mL) in the epidural space.
Study …show more content…
The randomization was performed using sealed envelopes indicating the group of the assignment at the time of the first visit to the pain clinic by a chief nurse, who read the number contained in the envelope and determined group assignments, but did not participate in patients’ follow-up.
Measurements
The assessment times were pre-enrollment and second week, first, second, fourth, sixth, eighth, tenth, and twelfth month and the following were recorded:
1. Pain on movement was evaluated by VAS 0 – 10
(where 0 means no pain and 10 means the worst common causes of spine pain and disability. The difficulty in diagnosis lies in the absence of clinical symptoms at rest, with pain and limitation of mobility described under physical strain (3,4).
Even though many studies demonstrated that surgery has better long-term results, a large number of people improved with nonsurgical intervention. Moreover, surgery is associated with high rates of complications relative to nonsurgical intervention (5). Epidural steroid injection has been increasingly employed for pain management in such patients who refuse