Abstract

ALVAREZ CORREA, Adelaida; RIVERA DIAZ, Roberto Carlo  and  ARCILA LOTERO, Mario Andrés. Efficacy of epidural methylprednisolone in radicular pain. Rev. colomb. anestesiol. [online]. 2015, vol.43, n.1, pp.61-67. ISSN 0120-3347.

Introduction: Degenerative disc disease is a prevalent and disabling disease. When the conservative treatment fails to obtain pain relief, epidural steroids are an alternative frequently used worldwide. Objectives: To evaluate the efficacy and safety of epidural methylprednisolone in patients with radicular pain. Methodology: Descriptive longitudinal retrospective study in patients with chronic radicular pain who received fluoroscopy-guided interventional treatment, between July 2010 and December 2011 at Instituto Colombiano del Dolor (Medellín-Colombia), to determine the efficacy and safety of epidural methylprednisolone in clinical practice. Pain relief was followed using the visual analogue scale, during at least 8 weeks. Results: 254 patients were analyzed. The mean age of the patients was 52.8 years (SD ± 15); 52.8% were men. The main diagnosis was lower-limb radicular pain (87.7%). The most frequent procedures were transforaminal lumbar injection (54.3%) and interlaminar lumbar injection (17.7%). The proportion of patients with more than 50% pain relief 50% was 85.8%. There were no differences in efficacy between the procedures. Pain improvement lasted more than 8 weeks in 55% of patients. The incidence of complications was lower than 1%. Conclusions: When radicular pain is refractory to conservative treatment based on pharmacological and physical therapy, epidural methylprednisolone is an effective and safe method in our setting.

Keywords : Pain; Steroids; Anesthesia; Epidural; Analgesia; Fluoroscopy.

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