Abstract | BACKGROUND: METHODS: A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. RESULTS: Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. CONCLUSIONS: The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.
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Authors | Laxmaiah Manchikanti, Peter S Staats, Devi E Nampiaparampil, Joshua A Hirsch |
Journal | The Korean journal of pain
(Korean J Pain)
Vol. 28
Issue 2
Pg. 75-87
(Apr 2015)
ISSN: 2005-9159 [Print] Korea (South) |
PMID | 25852828
(Publication Type: Journal Article, Review)
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