Epidural administration of anesthetics and corticosteroids in treatment of acute radicular pain syndrome of lumbar spine in neurosurgical department

Authors

  • Valeriy Olkhov Vinnytsa Regional Psychoneurological Hospital, Vinnitsa, Ukraine
  • O. Buyanov Vinnytsa Regional Psychoneurological Hospital, Vinnitsa, Ukraine
  • Kostyantyn Horbatyuk Vinnytsa Regional Psychoneurological Hospital, Vinnitsa, Ukraine
  • O. Kudina Vinnytsa Regional Psychoneurological Hospital, Vinnitsa, Ukraine
  • Leonid Ventskivskiy Vinnytsa Regional Psychoneurological Hospital, Vinnitsa, Ukraine
  • O. Borodenko Vinnytsa Regional Psychoneurological Hospital, Vinnitsa, Ukraine
  • Volodymyr Kirichenko Vinnytsa Regional Psychoneurological Hospital, Vinnitsa, Ukraine
  • Ivan Ventskivskiy Vinnytsa Regional Psychoneurological Hospital, Vinnitsa, Ukraine
  • Iurii Chyrka Vinnytsa Regional Psychoneurological Hospital, Vinnitsa, Ukraine
  • Ruslana Dolgopolova Vinnytsa Regional Psychoneurological Hospital, Vinnitsa, Ukraine

DOI:

https://doi.org/10.25305/unj.42450

Keywords:

lower back pain, epidural injection, corticosteroids

Abstract

The purpose. To estimate efficacy of epidural administration corticosteroids and local anesthetics at radicular pain syndromes associated with discoradicular conflict in lumbar spine.

Materials and methods. Epidural injection of corticosteroids and local anesthetics were used in 348 patients with radicular pain syndromes in lumbar spine in the Neurosurgical Department of Vinnytsa Regional Psychoneurological Hospital. Procedures were performed in the operating room under local anesthesia. We administrated betamethasone 2 ml and bupivacaine 0.5% 5 ml.

Results. Positive result was achieved in 86.8% cases. As a rule patients reported a reduction in pain intensity right after the procedure, the effect increased on the 2nd–3rd day. In 54 (15.5%) patients pain intensity reduced by 30–50% after the first injection, so we performed it again. In 46 (13.2%) patients there was no relief, they were operated for intensive pain.

Conclusions. Epidural administration of corticosteroids and local anesthetics is an effective method of neurosurgical treatment of pain syndromes in the lumbar spine and radicular pain caused by inflammation, this method is characterized by low risk level and is used as a criteria for determining whether to perform surgery.

Author Biographies

Valeriy Olkhov, Vinnytsa Regional Psychoneurological Hospital, Vinnitsa

Neurosurgery Department

O. Buyanov, Vinnytsa Regional Psychoneurological Hospital, Vinnitsa

Neurosurgery Department

Kostyantyn Horbatyuk, Vinnytsa Regional Psychoneurological Hospital, Vinnitsa

Neurosurgery Department

O. Kudina, Vinnytsa Regional Psychoneurological Hospital, Vinnitsa

Neurosurgery Department

Leonid Ventskivskiy, Vinnytsa Regional Psychoneurological Hospital, Vinnitsa

Neurosurgery Department

O. Borodenko, Vinnytsa Regional Psychoneurological Hospital, Vinnitsa

Neurosurgery Department

Volodymyr Kirichenko, Vinnytsa Regional Psychoneurological Hospital, Vinnitsa

Neurosurgery Department

Ivan Ventskivskiy, Vinnytsa Regional Psychoneurological Hospital, Vinnitsa

Neurosurgery Department

Iurii Chyrka, Vinnytsa Regional Psychoneurological Hospital, Vinnitsa

Neurosurgery Department

Ruslana Dolgopolova, Vinnytsa Regional Psychoneurological Hospital, Vinnitsa

Neurosurgery Department

References

Kondrashov AA, Polishchuk NE. Effektivnost' epidural'nogo vvedeniya steroidov u patsiyentov s foraminal'nymi gryzhami mezhpozvonkovykh diskov poyasnichnogo otdela pozvonochnika i koreshkovym sindromom [The effectiveness of epidural steroids in patients with foraminal hernias of intervertebral discs of the lumbar spine and radicular syndrome]. Odes Med Zhurn. 2010;3:50-55. Russian.

Suslov VV, Khizhnyak AA, Tarabrin OA, Fesenko UA, Fesenko BC. Epiduralnaya anesteziya i analgeziya [Epidural anesthesia and analgesia]. Kharkov: KHMAPO; 2011. Russian.

Staehler RA. Lumbar epidural steroid injections for low back pain and sciatica [Internet]. Deerfield, IL: Spine-health (US); 1999 Nov 1 [updated 2007 Jul 17; cited 2014 Aug 23]. Available from: http://www.spine-health.com/treatment/injections/lumbar-epidural-steroid-injections-low-back-pain-and-sciatica.

Lee H, Weinstein J, Meller S, Hayashi N, Spratt K, Gebhart G. The Role of Steroids and Their Effects on Phospholipase A2. Spine. 1998;23(11):1191-1196. CrossRef

Ahadian F, McGreevy K, Schulteis G. Lumbar Transforaminal Epidural Dexamethasone. Regional Anesthesia and Pain Medicine. 2011;36(6):572-578. CrossRef

Cluff R, Mehio A, Cohen S, Chang Y, Sang C, Stojanovic M. The Technical Aspects of Epidural Steroid Injections: A National Survey. Anesthesia & Analgesia. 2002;95(2):403-408. CrossRef

Vitenbek IA, Kovalenko GA, Isangulova ST, Kaganov NM. Pobochnyye reaktsii i oslozhneniya epidural'noy analgezii mestnymi anestetikami [Adverse reactions and complications of epidural local anesthetics]. Anesteziologiya i Reanimatologiya. 1987 ;5:62-66. Russian.

Manchikanti L, Cash KA, McManus CD, Pampati V, Fellows B. Results of 2-year follow-up of a randomized, double-blind, controlled trial of fluoroscopic caudal epidural injections in central spinal stenosis. Pain Physician. 2012 Sep-Oct;15(5):371-84.

Nelson D. Dangers From Methylprednisolone Acetate Therapy by Intraspinal Injection. Archives of Neurology. 1988;45(7):804-806. CrossRef

Kondrashov OA. Epidural'ne vvedennya steroyidiv v likuvanni dyskohennoho bol'ovoho syndromu poperekovoho viddilu khrebta [Epidural steroid injection for lumbar discogenic pain] [abstracts of dissertation]. Kiev: Romodanov Neurosurgery Institute; 2012. Ukrainian.

Published

2015-05-12

How to Cite

Olkhov, V., Buyanov, O., Horbatyuk, K., Kudina, O., Ventskivskiy, L., Borodenko, O., Kirichenko, V., Ventskivskiy, I., Chyrka, I., & Dolgopolova, R. (2015). Epidural administration of anesthetics and corticosteroids in treatment of acute radicular pain syndrome of lumbar spine in neurosurgical department. Ukrainian Neurosurgical Journal, (1), 51–54. https://doi.org/10.25305/unj.42450

Issue

Section

Original articles