Understanding Whether Chronic Lower back Pain Patients with Lumbar Spinal Stenosis Benefit from Multiple Epidural Steroid Injections Prior to the Mild^® Procedure

Abstract

Originally published in Pain Management, this article is a summary of a study performed to look at the benefit, if any, of more than one epidural steroid injection in the spine before the mild^® Procedure. Minimally invasive lumbar decompression (commonly known as the mild Procedure) and epidural steroid injections are both common treatment options for lumbar spinal stenosis (commonly referred to as LSS), a condition that causes chronic lower back pain in older adults.

To determine how to best treat LSS patients, healthcare professionals use a guide to help with the decision-making process (called an algorithm) to pass through non-medical to more invasive therapies that often includes one or more epidural steroid injections. An epidural steroid injection is medication inserted in the lower back to reduce swelling and provide relief from pain. Researchers wanted to look at a change to when in the treatment process the mild Procedure is carried out.

In the study, researchers compared the medical records of participants who had received either just one or no steroid injection prior to the mild Procedure, to participants who received two or more epidural steroid injections prior to the mild Procedure. Similar outcomes in both treatment groups in this study proved that giving more than one epidural steroid injection prior to the mild Procedure did not improve how well patients did and may have delayed patient care.

Based on the results of the study, it is recommended that the standard treatment process for LSS patients be changed to give the mild Procedure either as soon as LSS is diagnosed or after the failure of the first epidural steroid injection.

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Link to original article here.

Keywords::

• chronic back pain
• epidural steroid injection
• ESI
• hypertrophic ligamentum flavum
• lay summary
• lower back pain
• LSS
• LSS treatment options
• Lumbar spinal stenosis
• mild ^® Procedure
• minimally invasive lumbar decompression
• neurogenic claudication
• percutaneous image-guided lumbar decompression
• PILD
• plain language summary

This article is related to:

Minimally Invasive Direct Decompression for Lumbar Spinal Stenosis: Impact of Multiple Prior Epidural Steroid Injections

Financial & competing interests disclosure

P Pryzbylkowski: Consultant for Vertos Medical, Nevro and Camber Spine. A Bux: Consultant for Boston Scientific, Vertos Medical, AIS Healthcare and Flowonix. V Khemlani: Consultant for Vertos Medical and Biotronik. S Puri: Consultant for Omnia Medical. H Sukumaran: Consultant for Vertos Medical, Boston Scientific/Vertiflex, Nevro and SPR Therapeutics. J Rosenberg: Consultant for Vertos Medical, Abbott and Boston Scientific/Vertiflex. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Statistical analysis and manuscript assistance was funded by Vertos Medical. Medical writing and editorial assistance in the development of this article were provided by HighPoint Experience.

Acknowledgments

The authors would like to thank the Interventional Pain Community for its ongoing commitment to advancing patient care and improving the lives of patients who suffer from LSS.

Additional information

Funding

P Pryzbylkowski: Consultant for Vertos Medical, Nevro and Camber Spine. A Bux: Consultant for Boston Scientific, Vertos Medical, AIS Healthcare and Flowonix. V Khemlani: Consultant for Vertos Medical and Biotronik. S Puri: Consultant for Omnia Medical. H Sukumaran: Consultant for Vertos Medical, Boston Scientific/Vertiflex, Nevro and SPR Therapeutics. J Rosenberg: Consultant for Vertos Medical, Abbott and Boston Scientific/Vertiflex. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Statistical analysis and manuscript assistance was funded by Vertos Medical. Medical writing and editorial assistance in the development of this article were provided by HighPoint Experience.