RT Book, Section
A1 DeSio, John M.
A2 Warfield, Carol A.
A2 Bajwa, Zahid H.
SR Print(0)
ID 3420078
T1 Chapter 65. Epidural Steroid Injections
T2 Principles & Practice of Pain Medicine, 2e
YR 2004
FD 2004
PB The McGraw-Hill Companies
PP New York, NY
SN 9780071443494
LK accessanesthesiology.mhmedical.com/content.aspx?aid=3420078
RD 2024/04/19
AB The  administration  of  corticosteroids  into  the  epidural  space  to  relieve  both  acute  and  chronic  pain  of  spinal  origin  has  been  utilized  for  over  40  years.  In  1957  Lievre  et  al  reported  the  first  use  of  epidural  hydrocortisone  for  the  relief  of  back  pain  and  sciatica.1  Since  that  time  numerous  investigators  have  argued  both  for  and  against  the  efficacy  of  this  technique  versus  alternative  treatment  modalities  in  providing  significant  lasting  relief  for  patients  suffering  from  low  back  and  leg  pain.  In  1986  Benzon’s  review  of  the  literature  on  lumbar  epidural  steroid  injections  concluded  that  low  back  pain  of  mechanical  origin,  especially  accompanied  by  signs  of  nerve  root  irritation,  may  respond  to  epidural  steroid  injection.2  In  1988  Rosen  et  al,  performed  a  retrospective  analysis  of  the  efficacy  of  epidural  steroid  injections,  studying  40  patients  treated  for  low  back  pain  and  sciatica  secondary  to  spinal  stenosis  or  lumbar  herniated  disc.  They  concluded  that  50%  of  the  patients  with  radicular  symptoms  may  receive  temporary  relief  with  epidural  steroid  injection  (ESI);  long-term  relief,  however,  occurs  in  less  then  25%  of  patients  treated.3  In  most  studies  the  principal  indications  for  administering  epidural  steroid  injections  included  symptoms  of  low  back  pain  or  leg  pain  alone  or  in  combination  with  varying  selection  criteria  (e.g.,  previous  surgery,  duration  of  symptoms,  patient  age).