Matthew Schaeffer MD, Jeffrey Citara DO, Jimmy Miller
Premier Orthopaedic & Sports Medicine Associates, West Chester, PA
Objective: To determine if epidural injections of dexamethasone and methylprednisolone are equally effective.
Design. Sixty-two patients with lumbar radicular pain were randomized to receive equivalent doses of dexamethasone or methylprednisolone via transforaminal injection. Preoperative testing included visual analog scale and Oswestry Back Disability Index. Postoperative testing included visual analog scale at one and two weeks and three months. Oswestry Disability Index, Patient Satisfaction Survey and Pain Medication Reduction surveys were administered at two weeks and three months.
Results. Both groups demonstrated significant reductions on the visual analog scale at one and two weeks post-op. The methylprednisolone group maintained significant reduction on the visual analog scale at three months. Both groups demonstrated a decreased score on the Oswestry Disability Index at two weeks post-op and neither group maintained the significant reduction at three months.
There was no statistical difference in the patient satisfaction survey after two weeks (86% Methylprednisolone, 77% dexamethasone) or three months (81%, 77%).
There was statistical difference in the reduction of use of pain medications after two weeks (79% methylprednisolone, 57% dexamethasone) and three months (77%, 54%).
Conclusion: Methylprednisolone and Dexamethasone are near equally effective in the short term reduction of lumbar radicular pain. Methylprednisolone may be more effective than dexamethasone in sustained reduction of pain and in reducing the use of pain medications.
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