EPIDURAL STEROID REDUCES DISCOGENIC PAIN IN ACUTE FLARE UP OF DEGENERATIVE DISC DISEASE WITH MODIC CHANGES THAN CONSERVATIVE MANAGEMENT
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 10
Abstract
BACKGROUND Epidural Steroid Injection for radicular pain is an Effective method of treatment. No conclusive evidence exists to compare the efficacy of Epidural steroid injections (ESI) and conservative Management in Acute Flare up of Discogenic Pain in Degenerative Disc Disease (DDD). The aim and objective of the study is to determine the efficacy of Epidural Steroid injections and to compare the outcome with conservative mode of treatment in patients with acute flare up of DDD and to determine whether patients with inflammatory end plate changes are a unique subgroup in terms of treatment response. MATERIALS AND METHODS Pain and function in patients with DDD were prospectively assessed in 89 patients for a period of 1year by an outcomes questionnaire (VAS pain score, Oswestry Disability index [ODI]), Use of pain medication and Opinion of treatment success before and after ESI and a course of conservative management. Further correlation was made with end-plate inflammatory (Modic Type 1) changes identified on Magnetic Resonance Imaging (MRI) and compared. RESULTS ESI was effective in improving pain and function, as assessed by outcomes scores at short-term follow-up .Patients had significant improvement in the 6 months follow up when compared to conservative group (p<0.05). Patients with inflammatory end-plate changes seem to represent a subgroup of DDD patients who respond better to steroid injections. CONCLUSION Spinal Epidural steroid injections are low risk and rapid treatment option for acute flare up of Discogenic Pain in DDD. It is beneficial and more effective in patients with Modic type 1 adjacent inflammatory end plate MRI findings when compared to conservative management.
Authors and Affiliations
Suresh Bora, Hari Krishnan S. V
Keywords
Related Articles
- EP ID EP537681
- DOI 10.18410/jebmh/2018/186
- Views 69
- Downloads 0
STUDY OF LIPID PROFILE IN MALARIA- A PROGNOSTIC FACTOR
BACKGROUND Malaria is one of the most important parasitic infections human beings have ever known. Malaria is endemic in 91 countries with about 40% of world’s population at risk of acquiring the infection. Severe malari...
CERVICAL EPIDURAL BLOCK AS AN ALTERNATIVE TO GENERAL ANESTHESIA IN A PATIENT WITH ANTICIPATED DIFFICULT AIRWAY AND DERANGED THYROID FUNCTION FOR THYROID SURGERIES
Choosing safe anesthetic technique is pivotal role for anesthesiologist. It depends Age, preexisting systemic diseases and Type of surgery. In this case report we have chosen Cervical Epidural Block as an alternative to...
DEATH DUE TO CHOKING IN AN ELDERLY PSYCHIATRIC PATIENTA CASE REPORT
Choking is a form of asphyxial death in which there is blockage of internal airways. Mostly it is either accidental or homicidal. In accidental choking, the airways are usually blocked by a large food bolus or some forei...
INFLUENCE OF BODY MASS INDEX ON DISTANCE AND TEMPORAL CHARACTERISTICS OF GAIT IN CHILDREN WITH SPASTIC DIPLEGIA HAVING JUMP GAIT
BACKGROUND One of the leading causes of motor disability in children is cerebral palsy. 1 Various abnormal patterns of gait are described in this population of children. Jump gait is one of the common gait patterns in ch...
FIBROID ARISING FROM THE RUDIMENTARY UTERINE HORN IN MRKH SYNDROME
Uterovaginal agenesis, also known as Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare congenital anomaly affecting 1 in 4000 -5000 female births. It is the second most common cause of primary amenorrhoea characte...