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      KCI등재 SCOPUS

      Effects of Transforaminal Injection for Degenerative Lumbar Scoliosis Combined with Spinal Stenosis

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      https://www.riss.kr/link?id=A101634279

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      다국어 초록 (Multilingual Abstract)

      Objective The objectives of this study were to clarify the short-term effects of transforaminal epidural steroid injection (TFESI) for degenerative lumbar scoliosis combined with spinal stenosis (DLSS), and to extrapolate factors relating to the progn...

      Objective The objectives of this study were to clarify the short-term effects of transforaminal epidural steroid injection (TFESI) for degenerative lumbar scoliosis combined with spinal stenosis (DLSS), and to extrapolate factors relating to the prognosis of treatment.
      Method Thirty-six patients with lumbar radicular pain from DLSS were enrolled. Subjects were randomly assigned to one of two groups (steroid or lidocaine group). We compared the effect of pain suppression at 2, 4 and 12 weeks after the procedure between the two groups. Radiographic analysis included measurement of the Cobb’s angle, the upper endplate obliquities of L3 and L4, and maximal lateral olisthy between two adjacent lumbar vertebrae.
      Sagittal plane measurement included lumbar lordosis, and thoracolumbar kyphosis. Statistical analysis of both radiographic and clinical parameters along with treatment outcome was performed to determine any significant correlations between the two.
      Results There were no significant differences in the demographic data, initial visual analogue scale (VAS) or Oswestry disability index (ODI) between the steroid group (n=17) and the lidocaine group (n=19). Two, 4, and 12 weeks after injection VAS, ODI showed a significantly greater improvement in the steroid group compared to the lidocaine group (p<0.05). The radiographic and clinical parameters were not significantly correlated with treatment outcome.
      Conclusion Our findings suggest that fluoroscopic transforaminal epidural steroid injections appear to be an effective non-surgical treatment option for patients with degenerative lumbar scoliosis combined with spinal stenosis (DLSS) and radicular pain.

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      참고문헌 (Reference)

      1 Irwin ZN, "Variations in surgical decision making for degenerative spinal disorders" 30 : 2208-2213, 2005

      2 Delport EG, "Treatment of lumbar spinal stenosis with epidural steroid injections: a retrospective outcome study" 85 : 479-484, 2004

      3 Vad VB, "Transforaminal epidural steroid injections in lumbosacral radiculopathy: a prospective randomized study" 27 : 11-16, 2002

      4 Dawson E, "The surgical treatment of low back pain" 9 : 489-495, 1998

      5 Kostuik JP, "The incidence of low backpain in adult scoliosis" 6 : 268-273, 1981

      6 Ng L, "The efficacy of corticosteroids in periradicular infi ltration for chronic radicular pain: a randomized, double-blind, controlled trial" 30 : 857-862, 2005

      7 Nygaard OP, "Th e infl ammatory properties of contained and noncontained lumbar disc herniation" 22 : 2484-2488, 1997

      8 Riew KD, "Th e eff ect of nerve-root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double-blind study" 82 : 1589-1593, 2000

      9 Devor M, "Systemic lidocaine silences ectopic neuroma and DRG discharge without blocking nerve conduction" 48 : 261-268, 1992

      10 Fukusaki M, "Symptoms of spinal stenosis do not improve after epidural steroid injection" 14 : 148-151, 1998

      1 Irwin ZN, "Variations in surgical decision making for degenerative spinal disorders" 30 : 2208-2213, 2005

      2 Delport EG, "Treatment of lumbar spinal stenosis with epidural steroid injections: a retrospective outcome study" 85 : 479-484, 2004

      3 Vad VB, "Transforaminal epidural steroid injections in lumbosacral radiculopathy: a prospective randomized study" 27 : 11-16, 2002

      4 Dawson E, "The surgical treatment of low back pain" 9 : 489-495, 1998

      5 Kostuik JP, "The incidence of low backpain in adult scoliosis" 6 : 268-273, 1981

      6 Ng L, "The efficacy of corticosteroids in periradicular infi ltration for chronic radicular pain: a randomized, double-blind, controlled trial" 30 : 857-862, 2005

      7 Nygaard OP, "Th e infl ammatory properties of contained and noncontained lumbar disc herniation" 22 : 2484-2488, 1997

      8 Riew KD, "Th e eff ect of nerve-root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double-blind study" 82 : 1589-1593, 2000

      9 Devor M, "Systemic lidocaine silences ectopic neuroma and DRG discharge without blocking nerve conduction" 48 : 261-268, 1992

      10 Fukusaki M, "Symptoms of spinal stenosis do not improve after epidural steroid injection" 14 : 148-151, 1998

      11 Robin GC, "Scoliosis in the elderly: a follow- up study" 7 : 355-359, 1982

      12 Grubb SA, "Results of surgical treatment of painful adult scoliosis" 19 : 1619-1627, 1994

      13 Nasca RJ, "Rationale for spinal fusion in lumbar sipnal stenosis" 14 : 451-454, 1989

      14 Jackson RP, "Radiographic analysis of sagittal plane alignment and balance in standing volun teers and patients with low back pain matched for age,sex, and size. A prospective controlled clinical study" 19 : 1611-1618, 1994

      15 Rydevik B, "Pathoanatomy and pathophysiology of nerve root compression" 9 : 7-15, 1984

      16 Swezey RL, "Outcome for lumbar stenosis" 2 : 129-134, 1996

      17 van Dam BE, "Nonoperative treatment of adult scoliosis" 19 : 347-351, 1988

      18 Simotas AC, "Nonoperative treatment for lumbar spinal stenosis. Clinical and outcome results and a 3-year survivorship analysis" 25 : 197-203, 2000

      19 Cannon DT, "Lumbosacral epidural steroid injections" 81 (81): S87-S98, 2000

      20 Onel D, "Lumbar spinal stenosis: clinical/radiologic therapeutic evaluation in 145 patients. Conservative treatment or surgical intervention" 18 : 291-298, 1993

      21 Johansson A, "Local corticosteroid application blocks transmission in normal nociceptor C-fi bres" 34 : 335-338, 1990

      22 Gallos G, "Local anesthetics reduce mortality and protect against renal and hepatic dysfunction in murine septic peritonitis" 101 : 902-911, 2004

      23 Lahat A, "Lidocaine down-regulates nuclear factorkappaB signalling and inhibits cytokine production and T cell proliferation" 152 : 320-327, 2008

      24 Johnson HG, "Inhibition of histamine release and ionophore-induced calcium flux in rat mast cells by lidocaine and chlorpromazine" 9 : 239-243, 1979

      25 Olmarker K, "Infl ammatogenic properties of nucleus pulposus" 20 : 665-669, 1995

      26 Franson RC, "Human disc phospholipase A2 is inflammatory" 17 (17): S129-S132, 1992

      27 Lutz GE, "Fluoroscopic trans foraminal lumbar epidural steroids: an outcome study" 79 : 1362-1366, 1998

      28 Hoogmartens M, "Epidural injection in the treatment of spinal stenosis" 53 : 409-411, 1987

      29 Cooper G, "Eff ectiveness of transforaminal epidural steroid injections in patients with degenerative lumbar scoliotic stenosis and radiculopathy" 7 : 311-317, 2004

      30 Olmarker K, "Edema formation in spinal nerve roots induced by experimental, graded compression. An experimental study on the pig cauda equina with special reference to diff erences in eff ects between rapid and slow onset of compression" 14 : 569-573, 1989

      31 Grubb SA, "Diagnostic fi ndings in painful adult scoliosis" 17 : 518-527, 1992

      32 Pritchett JW, "Degenerative symptomatic lumbar scoliosis" 18 : 700-703, 1993

      33 Grubb SA, "Degenerative adult onset scoliosis" 13 : 241-245, 1988

      34 Kantrowitz F, "Corticosteroids inhibit prostaglandin production by rheumatoid synovia" 258 : 737-739, 1975

      35 Kluba T, "Comparison of surgical and conservative treatment for degenerative lumbar scoliosis" 129 : 1-5, 2009

      36 Miyamoto H, "Clinical outcome of nonoperative treatment for lumbar spinal stenosis, and predictive factors relating to prognosis, in a 5-year minimum follow-up" 21 : 563-568, 2008

      37 Cassuto J, "Anti-inflammatory properties of local anesthetics and their present and potential clinical implications" 50 : 265-282, 2006

      38 Schwab FJ, "Adult scoliosis: a quantitative radiographic and clinical analysis" 27 : 387-392, 2002

      39 Nash CL Jr, "A study of vertebral rotation" 51 : 223-229, 1969

      40 Rosen CD, "A retrospective analysis of the efficacy of epidural steroid injections" 228 : 270-272, 1988

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      2016 0.19 0.19 0.17
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