Pain Pract. 2021 Apr 19. doi: 10.1111/papr.13018. Online ahead of print.
ABSTRACT
BACKGROUND: SNRB was shown to effectively control radiating pain and reduce the need for surgical intervention. However, repetitive injections may trigger corticosteroid-induced side effects (hypercorticism, hyperglycemia, or fluid retention). This study aims to compare the potency of hyaluronic acid-carboxymethylcellulose (HA-CMC) solution versus that of corticosteroids regarding lower leg radiating pain (LLRP) improvement and functional outcome.
METHODS: Among 128 patients, 44 patients who complain LLRP due to lumbar spinal stenosis and do not have neurological symptoms requiring surgery were enrolled for this study. Group A with 22 patients injected with cocktail A (local anesthetics, corticosteroid) and group B with 22 patients injected with cocktail B (local anesthetics, HA-CMC). Outcome measures were the visual analog scale (VAS), Oswestry Disability Index (ODI), and short form -36 (SF-36). All patients were asked to fill in the questionnaires during the follow-up assessment period at 3 days, 7 days, 2 weeks, 6 weeks, and 12 weeks.
RESULTS: In all time periods, there were no statistical differences between the two groups for VAS scores and VAS improvement over time, ODI scores and ODI improvement over time, and SF-36 PCS scores and SF-36 MCS scores. Additionally, the 95% confidence interval of the difference in VAS score improvement between the two groups in all time periods was within VAS 5.0, which is the minimum clinically relevant difference.
CONCLUSIONS: Considering the adverse effects of corticosteroids, and the similar LLRP improvements, functional outcome, and quality of life, the HA-CMC solution may be an alternative option to corticosteroid in SNRB.
PMID:33872462 | DOI:10.1111/papr.13018
