Сomparative effectiveness of various methods of epidural administration of glucocorticosteroids in treating root pain syndromes
- 作者: Fedorov D.1,2, Khinovker V.1,2, Koriachkin V.3
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隶属关系:
- Federal Siberian Research Clinical Centre
- Krasnoyarsk State Medical University
- Saint-Petersburg State Pediatric Medical University
- 期: 卷 16, 编号 1 (2022)
- 页面: 59-70
- 栏目: Reviews
- URL: https://journals.rcsi.science/1993-6508/article/view/108077
- DOI: https://doi.org/10.17816/1993-6508-2022-16-1-59-70
- ID: 108077
如何引用文章
详细
This review aimed to compare the effectiveness of different methods of epidural glucocorticosteroid (GCS) use in the treatment of root syndrome pain according to literature over the past 20 years. A literary search was conducted in the databases of PubMed, MEDLINE, EMBASE, Cochrane Library, and Google Scholar, as well as a manual search of bibliographies of famous primary and review articles and abstracts of scientific meetings between 2000 and 2020. During the search, 637 studies were identified, of which 615 were excluded, as they did not correspond to the topic of the article. The remaining 22 studies were included in this review.
Scientific papers describe three ways to deliver glucocorticosteroids, namely, epidural–interlaminar injection, transforaminal injection, sacral–epidural injection.
For sciatica, 5 out of 8 comparative randomized controlled trials found the transforaminal route of administration to be superior to the sacroepidural or interlaminar route of administration. In a number of studies, the sacroepidural route of administration was comparable in efficiency with transfor-real with low herniated discs.
In cases of cervicobrachialgia, the transforaminal route of administration is recognized by most authors as unsafe, with risks of accidental intravascular injection. In this regard, at the cervical level, interlaminar access is considered preferable. In addition, the differences between the epidural use of water-soluble and dispersed (not approved for use in the Russian Federation) glucocorticosteroids are described.
The review describes the techniques of various approaches to the epidural space with their advantages and disadvantages.
Different methods require different material equipment of clinics. Sacral access, with relatively high efficiency, allows for “blind” use, in contrast to transforaminal access at the lumbar level and interlaminar access at the cervical level, which require X-ray navigation.
作者简介
Dmitry Fedorov
Federal Siberian Research Clinical Centre; Krasnoyarsk State Medical University
Email: 293333666fedorov@gmail.com
ORCID iD: 0000-0002-1860-4609
SPIN 代码: 6912-7740
anesthesiologist
俄罗斯联邦, Krasnoyarsk; KrasnoyarskVladimir Khinovker
Federal Siberian Research Clinical Centre; Krasnoyarsk State Medical University
编辑信件的主要联系方式.
Email: vhinov@hotmail.com
ORCID iD: 0000-0002-3162-6298
SPIN 代码: 8640-9591
MD, Cand. Sci. (Med.)
俄罗斯联邦, 26, 2, Kolomenskaya st., Krasnoyarsk, 660037; KrasnoyarskViktor Koriachkin
Saint-Petersburg State Pediatric Medical University
Email: vakoryachkin@mail.ru
ORCID iD: 0000-0002-3400-8989
SPIN 代码: 6101-0578
MD, Dr. Sci. (Med.), professor
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补充文件
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