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Particulate versus non-particulate corticosteroids for transforaminal nerve root blocks: Comparison of outcomes in 494 patients with lumbar radiculopathy

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Purpose

We set out to compare outcomes in CT-guided lumbar transforaminal nerve root block patients receiving either particulate or non-particulate corticosteroids.

Materials and methods

This was a retrospective comparative effectiveness outcomes study on two cohorts of lumbar radiculopathy patients. 321 received particulate and 173 non-particulate corticosteroids at CT-guided transforaminal lumbar nerve root injections. The particulate steroid was used from October 2009 until May 2014 and the non-particulate steroid was used from May 2014. Pain levels were collected at baseline using an 11-point numerical rating scale (NRS) and at 1 day, 1 week and 1 month. Overall ‘improvement’ was assessed using the Patients’ Global Impression of Change (PGIC) at these same time points (primary outcome). The proportions of patients ‘improved’ were compared between the two groups using the Chi-square test. The NRS change scores were compared using the unpaired t-test.

Results

A significantly higher proportion of patients treated with particulate steroids were improved at 1 week (43.2 % vs. 27.7 %, p = 0.001) and at 1 month (44.3 % vs. 33.1 %, p = 0.019). Patients receiving particulate steroids also had significantly higher NRS change scores at 1 week (p = 0.02) and 1 month (p = 0.007).

Conclusion

Particulate corticosteroids have significantly better outcomes than non-particulate corticosteroids.

Key Points

• Better pain relief is achieved with particulate steroids.

• Significantly more patients report overall ‘improvement’ with particulate steroids.

• Significantly more patients report ‘worsening’ at 1 week with non-particulate steroids.

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Orthopaedic University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland

    Susanne Bensler, Reto Sutter, Christian W. A. Pfirrmann & Cynthia K. Peterson

  2. Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland

    Susanne Bensler, Reto Sutter, Christian W. A. Pfirrmann & Cynthia K. Peterson

Authors
  1. Susanne Bensler
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  2. Reto Sutter
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  3. Christian W. A. Pfirrmann
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  4. Cynthia K. Peterson
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Corresponding author

Correspondence to Susanne Bensler.

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Guarantor

The scientific guarantor of this publication is Susanne Bensler.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional review board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Bensler, S., Sutter, R., Pfirrmann, C.W.A. et al. Particulate versus non-particulate corticosteroids for transforaminal nerve root blocks: Comparison of outcomes in 494 patients with lumbar radiculopathy. Eur Radiol 28, 946–952 (2018). https://doi.org/10.1007/s00330-017-5045-z

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  • DOI: https://doi.org/10.1007/s00330-017-5045-z

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