alexa The use of lumbar epidural transforaminal steroids for managing spinal disease.
Medicine

Medicine

Journal of Medical Diagnostic Methods

Author(s): Young IA, Hyman GS, PackiaRaj LN, Cole AJ

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Abstract Lumbar epidural steroid injections are used to manage low back and leg pain (ie, sciatica). Utilization of the procedure is increasing, with Medicare spending for lumbar epidural procedures topping $175 million annually. Few prospective randomized controlled trials have clearly demonstrated the efficacy of epidural steroid injections; many have shown conflicting results. Several studies show favorable short-term outcomes with epidural steroid injection for radicular pain, but less conclusive results are achieved >6 months. Methodologic flaws limit interpretation of results from most scientific studies. As a tool for predicting surgical outcome, epidural spinal injection has been found to have a sensitivity between 65\% and 100\%, a specificity between 71\% and 95\%, and a positive predictive value as high as 95\% for 1-year surgical outcome. Despite inconclusive evidence, when weighing the surgical alternatives and associated risk, cost, and outcomes, lumbar epidural steroid injections are a reasonable nonsurgical option in select patients.
This article was published in J Am Acad Orthop Surg and referenced in Journal of Medical Diagnostic Methods

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