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2017 ; 7
(6
): e62556
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Electromyographic Findings After Epidural Steroid Injections in Patients with
Radicular Low Back Pain: A Prospective Open-Label Study
#MMPMID29696128
Batistaki C
; Angelopoulou A
; Smyrnioti ME
; Kitsou MC
; Kostopanagiotou G
Anesth Pain Med
2017[Dec]; 7
(6
): e62556
PMID29696128
show ga
Epidural steroid injections (ESIs) are commonly used in the management of chronic
lower back and leg pain. The aim of this study was to investigate the short- and
long-term electromyographic and clinical outcome of patients with chronic
radicular pain after ESIs. This prospective, open-label study, included patients
with chronic radicular pain due to disc herniation or spinal stenosis, who
underwent interlaminar, fluoroscopy-guided ESIs. Patients were assessed before
ESIs, as well as after 6 and 12 months, clinically (VAS 0-10, BPI, DN4, Rolland
Morris, DASS, STAI) and electromyographically for the improvement of spontaneous
activity (SA) and of motor unit recruitment/interference pattern (IP/MUR). A
total of 39 patients were studied, 20 (51.3%) who had a significant improvement
in VAS, RM, DN4 and BPI were revealed, mainly during the first 6 months (P <
0.05). Statistically significant improvement was revealed in MUR/SA for almost
all nerve roots studied. Patients with disc herniation showed a greater
improvement in mean difference of MUR/SA (P < 0.05) (with a prognostic value of
radicular LBP versus spinal stenosis in short- [VAS P = 0.042] and long-term
improvement of pain [VAS P = 0.009]. The independent variables "MUR" and "SA" had
a significant prognostic value for improvement of pain (VAS: R(2) = 0.287, P =
0.032 and VAS: R(2) = 0.277, P = 0.036 respectively). Electromyographic and
clinical findings indicated a benefit from epidural steroid injections. Patients
with disc herniation exhibited a better outcome, especially during the first 6
months post-treatment.