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Intradiscal steroid therapy in chronic discogenic pain: a systematic review of literature
, 2, 1
Affiliations- Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, India
- Aiims Rishikesh, Dehradun, Rishikesh, India
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Abstract
Background: This article aims to conduct a systematic review of the present literature and assess the use of intra-discal steroids injection (IDSI) for patients suffering from chronic discogenic back pain irresponsive to conservative treatment.
Methods: The search was conducted in PubMed, PubMed Central, Cochrane, Scopus, Embase, and Google Scholar databases between 1990 and 2021. Included were studies assessing the administration of IDSI to adults suffering from chronic discogenic back pain. Studies evaluating combination interventions were excluded. The quality of evidence was determined by the GRADE assessment. The PROSPERO registration number for the review is CRD42022307690.
Results: Eight studies enrolling a total of 548 patients were finally included in the systematic review. A significant reduction in pain scores after IDSI was calculated one month after intervention [standardized mean difference (SMD) −1.32 (−2.32, −0.31), p = 0.01, I2 = 89%]. This effect was not sustained at three- six- and twelve-month assessments. The analysis revealed no therapeutic benefit of intra-discal steroids for disability and activity limitation at one month, [SMD −0.76 (−1.88, 0.36), p = 0.18, I2 = 92%], three-, six- or twelve-months intervals. Overall, the quality of effect estimates was found to be moderate.
Conclusions: The authors believe that Intradiscal steroid therapy can only be used as a bridge therapy for short-term pain relief while the patient with chronic discogenic pain awaits another intervention or surgery.
Abstract
Background: This article aims to conduct a systematic review of the present literature and assess the use of intra-discal steroids injection (IDSI) for patients suffering from chronic discogenic back pain irresponsive to conservative treatment.
Methods: The search was conducted in PubMed, PubMed Central, Cochrane, Scopus, Embase, and Google Scholar databases between 1990 and 2021. Included were studies assessing the administration of IDSI to adults suffering from chronic discogenic back pain. Studies evaluating combination interventions were excluded. The quality of evidence was determined by the GRADE assessment. The PROSPERO registration number for the review is CRD42022307690.
Results: Eight studies enrolling a total of 548 patients were finally included in the systematic review. A significant reduction in pain scores after IDSI was calculated one month after intervention [standardized mean difference (SMD) −1.32 (−2.32, −0.31), p = 0.01, I2 = 89%]. This effect was not sustained at three- six- and twelve-month assessments. The analysis revealed no therapeutic benefit of intra-discal steroids for disability and activity limitation at one month, [SMD −0.76 (−1.88, 0.36), p = 0.18, I2 = 92%], three-, six- or twelve-months intervals. Overall, the quality of effect estimates was found to be moderate.
Conclusions: The authors believe that Intradiscal steroid therapy can only be used as a bridge therapy for short-term pain relief while the patient with chronic discogenic pain awaits another intervention or surgery.
Keywords
intradiscal injection, low back pain, intradiscal steroids, discogenic pain, systematic review, palliative care
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About this articleTitle
Intradiscal steroid therapy in chronic discogenic pain: a systematic review of literature
Journal
Palliative Medicine in Practice
Issue
Article type
Review paper
Pages
152-163
Published online
2023-03-28
Page views
247
Article views/downloads
353
DOI
Bibliographic record
Palliat Med Pract 2023;17(3):152-163.
Keywords
intradiscal injection
low back pain
intradiscal steroids
discogenic pain
systematic review
palliative care
Authors
Priyanka Mishra
Sonal Goyal
Robina Makker
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