Abstract
Objectives
The main objective of our study was to determine the treatment effect of corticosteroids in peri-radicular infiltration for radicular pain. We also examined whether there was any effect on the need for subsequent interventions such as additional root blocks and/or surgery.
Subjects and Method
In a randomised, double blind controlled trial, 150 eligible patients with radicular pain and unilateral symptoms who failed conservative management were randomised for a single injection with bupivacaine and methylprednisolone (b+s) or bupivacaine (b) alone. The outcome measures used included the Oswestry Disability Index (ODI), Low Back Outcome Score (LBOS), Visual Analogue Score (VAS) for leg pain and back pain and patient's subjective level of satisfaction of the outcome.
Results
We recruited 76 patients in the b only group and 74 patients in the b+s group. There was no statistically significant difference in the outcome measures between the groups at 3 months (change in ODI [p=0.2], change in VAS [back pain, p=0.28; leg pain, p=0.67]. Subgroup analysis revealed that there was no statistically significant difference in the change in scores between the stenotic group and disc herniation group at 3 months. At 1 year follow-up data was available for 86% of the patients. There was no statistically significant difference in the rate of further interventions in either group.
Conclusion
Clinical improvement occurs in both groups of patients. Corticosteroids did not provide additional benefit. There is no difference in the need for further root blocks or surgery.
