Abstract | CONTEXT: EVIDENCE ACQUISITION: Recent randomized trials, systematic reviews and guidelines have reached varying conclusions about the efficacy of epidural injections in the management of central lumbar spinal stenosis. The aim of this systematic review was to determine the efficacy of all three anatomical epidural injection approaches (caudal, interlaminar, and transforaminal) in the treatment of lumbar central spinal stenosis. A systematic review was performed on randomized trials published from 1966 to July 2014 of all types of epidural injections used in the management of lumbar central spinal stenosis. Methodological quality assessment and grading of the evidence was performed. RESULTS: The evidence in managing lumbar spinal stenosis is Level II for long-term improvement for caudal and lumbar interlaminar epidural injections. For transforaminal epidural injections, the evidence is Level III for short-term improvement only. The interlaminar approach appears to be superior to the caudal approach and the caudal approach appears to be superior to the transforaminal one. CONCLUSIONS:
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Authors | Laxmaiah Manchikanti, Alan David Kaye, Kavita Manchikanti, Mark Boswell, Vidyasagar Pampati, Joshua Hirsch |
Journal | Anesthesiology and pain medicine
(Anesth Pain Med)
Vol. 5
Issue 1
Pg. e23139
(Feb 2015)
ISSN: 2228-7523 [Print] Netherlands |
PMID | 25789241
(Publication Type: Journal Article, Review)
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