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Titre : | Factors Associated With Pain Reduction After Transforaminal Epidural Steroid Injection for Lumbosacral Radicular Pain (2014) |
Auteurs : | Zachary McCormick ; Daniel Cushman ; Ellen Casey |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2014/12, 2014) |
Article en page(s) : | p. 2350-2356 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Dorsalgie ; Rééducation et réadaptation |
Mots-clés: | Back pain ; Injections ; epidural ; Injections épidurales ; Lumbosacral region ; Région lombosacrale ; Radiculopathy ; Radiculopathie |
Résumé : |
Objective To identify demographic and clinical factors associated with pain improvement after a lumbosacral transforaminal epidural steroid injection (TFESI) for the treatment of radicular pain. Design Retrospective cohort study. Setting Outpatient center. Participants Adults (N=188) who underwent a fluoroscopically guided TFESI for lumbosacral radicular pain. Interventions Not applicable. Main Outcome Measures Pain reduction from preinjection to 2-week follow-up was measured by visual analog scale (VAS). Patients were grouped by those who experienced no pain relief or worsened pain (≤0%), pain relief but 0% Results The mean duration of pain prior to injection was 45.8+81 weeks. The mean time to follow-up after TFESI was 20+14.2 days. Significantly more patients who experienced ≥50% pain relief at follow-up reported higher preinjection pain on the VAS (P=.0001) and McGill Pain Inventory Questionnaire (P=.0358), reported no worsening of their pain with walking (P=.0161), or had a positive femoral stretch test (P=.0477). No significant differences were found between VAS pain reduction and all other demographic and clinical factors, including a radiologic diagnosis of disk herniation versus stenosis or other neural tension signs on physical examination. Conclusions Greater baseline pain on the VAS and McGill Pain Inventory, a history of a lack of worsening pain with walking, and a positive femoral stretch test predict a greater likelihood of pain reduction after TFESI for lumbosacral radicular pain at short-term follow-up. Greater baseline pain on the McGill Pain Inventory and a lack of worsening pain with walking predict a magnitude of >50% pain reduction. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999314009319 |