Abstract
Lumbosciatica is a frequent reason for consultation in general medicine and emergency medicine with an estimated incidence between 2% and 14%. There are several therapeutic modalities, including infiltrations, which are very controversial. Based on this observation, we conducted a prospective study in which 19 patients had undergone epidural and peri-radicular infiltration; the epidural was the most represented infiltration in 68.4% of the patients, the peri-radicular was in 21.1% of them and the combination of both was in 10.5% of the cases, with only 30.6% of the infiltrations carried out under radioscopy. The molecules used were Triamcinolone Acetonide-based Kenacort and Methylprednisolone Acetate-based Depo-Medrol. The evolution of post-infiltration pain decreased significantly in 94.7% of cases, with a statistically significant difference (p = 0.04). No complications were observed in our patients and none of them had resorted to surgery during the follow-up period except for a single case of recurrence of pain relieved by periodic spaced infiltrations. Despite the small size of our sample, we can conclude that infiltration techniques still have a place in the management of Lumbosciatica alongside the surgery.
Highlights
We conducted a prospective study in which 19 patients had undergone epidural and peri-radicular infiltration; the epidural was the most represented infiltration in 68.4% of the patients, the peri-radicular was in 21.1% of them and the combination of both was in 10.5% of the cases, with only 30.6% of the infiltrations carried out under radioscopy
A meta-analysis of 87 services showed a satisfaction rate of at least 65%. The limitations of these studies remain so considerable that none of them mentions a reduction in the use of surgery [4], which motivated us to carry out a prospective study to evaluate the impact of infiltrations on the evolution of lumbosciatica in our hospital
From the review of the literature, we note that the evolution of lumbosciatica due to disc herniation is often favourable to non-surgical treatment and the infiltrations would remain the recourse in case of failure of other medical means
Summary
In case of failure of the previous treatments, spinal corticosteroid infiltrations are widely practiced [2]. Their usefulness remains controversial in particular because of the lack of studies documenting their effectiveness with a satisfactory level of proof [3]. A meta-analysis of 87 services showed a satisfaction rate of at least 65%. The limitations of these studies remain so considerable that none of them mentions a reduction in the use of surgery [4], which motivated us to carry out a prospective study to evaluate the impact of infiltrations on the evolution of lumbosciatica in our hospital
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