Evaluation of Treatment of Herniated Lumbar Disc Sciatica by Epidural Corticosteroid Injection

  • Quang-Tri LE LE QuangTri, MD, PhDDirector of7A MILITARY HOSPITALHeadof Department of Orthopedic, 7AMILITARY HOSPITAL466 NguyenTrai Street, Ward 8, District 5, Ho Chi Minh City, 72706VietnamPhone:(+084)08-39241868, (+084)0913126229
  • Minh-Hoang Nguyen Thanh-Hoang Nguyen, Department of Orthopedic, 7A Military Hospital 466 Nguyen Trai Street, Ward 8, District 5, Ho Chi Minh City, 72706 Vietnam (hoangbss@gmail.com)

Abstract

Background: Medical facilities in Vietnam both use Methylprednisolone acetate and Hydrocortisone acetate in treatment with different administrations. This study aimed to evaluate of effects and side-effects of epidural injection of Methylprednisolone acetate and Hydrocortisone acetate in the treatment of herniated lumbar disc sciatica.


Methods and findings: Cross-sectional descriptive study on 80 herniated lumbar disc sciatica patients treated at Department of Orthopedic, 7A Military Hospital, Hochiminh City, VietNam. The patients were divided into two groups in coupling fashion based on the VAS score of pain.


Study results showed that both corticosteroid drugs (Methylprednisolone acetate and Hydrocortisone acetate) yielded good outcomes on all investigated parameters and there was no significant difference between the two medications (p < 0.05); administration of Methylprednisolone acetate reduced VAS score of 1.98 ± 1.33 points and Hydrocortisone acetate reduced of 2.13 ± 1.17 points. Lasegue test score in Methylprednisolone acetate administered patients raised from 74.630 ± 18.820 to 80.750 ± 15.870 and in Hydrocortisone acetate patients from 71.250 ± 10.110 to 81.630 ± 8.350). Treatment methods were safe, and there was no difference in complication rates between the two groups. The direct and indirect cost of Hydrocortisone acetate administration was three times higher than Methylprednisolone acetate.


Conclusion: It was safe and effective to administrate both Methylprednisolone acetate and Hydrocortisone acetate in the treatment of herniated lumbar disc sciatica. Methylprednisolone acetate administration was more economical than Hydrocortisone acetate.


Keywords: Sciatica, epidural injection, Methylprednisolone acetate, Hydrocortisone acetate

References

1. Wang YC, Chiu YS, Yeh CH. Leriche's syndrome presenting as sciatica. Ann Vasc Surg. 2010 Jul; 24(5):694.e1-e3.
2. Kim WH, Lee SH, Lee DY (2011). Changes in the cross-sectional area of multifidus and psoas in unilateral sciatica caused by lumbar disc herniation. J Korean Neurosurg Soc. 2011 Sep;50(3):201-04.
3. Ropper AH, Zafonte RD. Sciatica. N Engl J Med. 2015 Mar;372(13):1240-8.
4. Valat JP, Genevay S, Marty M, Rozenberg S, Koes B. Sciatica. Best Pract Res Cl Rh. Apr 2010;24(2):241-52.
5. Nguyen Thi NL, Hoang HS, Nguyen VN. Several risk factors account for herniated disc sciatica in the community. Vietnam J Med Special Issue. 2011 Jul:58-63. (in Vietnamese)
6. Nguyen TH. Remarks on herniated disc sciatica treatment in Musculoskeletal Department, Bach Mai Hospital [dissertation]. Hanoi: Hanoi Medical University; 2011. (in Vietnamese)
7. Nguyen MH. Compare of clinical traits and MRI of lumbar spine disc herniation [master dissertation]. Hanoi: Hanoi Medical University; 2009. (in Vietnamese)
8. Arjmand N, Plamondon A, Shirazi-Adl A, Parnianpour M, Larivière C. (2012). Predictive equations for lumbar spine loads in load-dependent asymmetric one-and two-handed lifting activities. Clin Biomech. 2012 Jul;27(6): 537-44.
9. Miwa S, Yokogawa A, Kobayashi T, Nishimura T, Igarashi K, Inatani H, Tsuchiya H. Risk Factors of Recurrent Lumbar Disk Herniation. J Spinal Disord Tech. 2015 Jun;28(5):E265-9.
10. Tafazzol A, Aref S, Mardani M, Haddad O, Parnianpour M. Epidemiological and biomechanical evaluation of airline baggage handling. Int J Occup Saf Ergon. 2016 Mar;22(2):218-27.
11. Manson NA, McKeon MD, Abraham EP. Transforminal epidural steroid injections prevent the need for surgery un patients with sciatica secondary to lumbar disc herniation: a retrospective case series. 24th Annual North American Spine Society Meeting in San Francisco, California, 2009 Nov 10; San Francisco, California. DOI: 101530/cjs.014611.
12. Riew KD, Park JB, Cho YS, Gilula L, Patel A, Lenke LG et al. Nerve root blocks in the treatment of lumbar radicular pain: A minimum fve-years follow-up. J Bone Joint Surg Am. 2006 Aug;8(8):1722-5.
13. Runu R, Sinha NK, Pai R, Shankar PR, Vijayabhaskar P (2005), Our experience with epidural steroid injections in management of low back pain and sciatica. Kathmandu Univ Med J. 2005 Oct;3(4(12)): 349-54.
Published
2020-02-04
How to Cite
LE, Quang-Tri; NGUYEN, Minh-Hoang. Evaluation of Treatment of Herniated Lumbar Disc Sciatica by Epidural Corticosteroid Injection. International Archives of Medicine, [S.l.], v. 13, feb. 2020. ISSN 1755-7682. Available at: <http://imedicalpublisher.com/ojs/index.php/iam/article/view/2918>. Date accessed: 19 jan. 2021. doi: https://doi.org/10.3823/2620.
Section
Internal Medicine & Hospital Medicine