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At least 685 records · Page 38Linked to original sources
PubMed2007

Sciatica: treatment with intradiscal and intraforaminal injections of steroid and oxygen-ozone versus steroid only.

PURPOSE: To prospectively compare the clinical effectiveness of intraforaminal and intradiscal injections of a mixture of a steroid, a local anesthetic, and oxygen-ozone (O(2)-O(3)) (chemodiscolysis) versus intraforaminal and intradiscal injections of a steroid and an anesthetic in the management of radicular pain related to acute lumbar disk herniation. MATERIALS AND METHODS: Medical Ethical Committee approval and informed consent were obtained. One hundred fifty-nine patients (86 men, 73 women; age range, 18-71 years) were included and were randomly assigned to two groups. Seventy-seven patients (group A) underwent intradiscal and intraforaminal injections of a steroid and an anesthetic, and 82 patients (group B) underwent the same treatment with the addition of an O(2)-O(3) mixture. Procedures were performed with computed tomographic guidance. An Oswestry Low Back Pain Disability Questionnaire was administered before treatment and at intervals, the last at 6-month follow-up. Patients and clinicians were blinded as to which treatment was performed. Results were compared with the chi(2) test. RESULTS: After 6 months, treatment was successful in 36 (47%) patients in group A and in 61 (74%) patients in group B. The difference was significant (P < .01). CONCLUSION: Intraforaminal and intradiscal injections of a steroid, an anesthetic, and O(2)-O(3) are more effective at 6 months than injections of only a steroid and an anesthetic in the same sites.

Adolescent↗
PubMed1988

Dorsal root entry zone coagulation for intractable sciatica.

Chronic back and leg pain which is unresponsive to medical and/or surgical treatment is a common and difficult neurosurgical problem. Twelve patients with this condition underwent dorsal root entry zone coagulation of that region of the conus medullaris which correlated with the pain. Only 2 patients had a favorable result. The implications of this finding are discussed.

Adult↗
PubMed2005

Neural-immune interactions: implications for pain management in patients with low-back pain and sciatica.

Bidirectional communication between the immune system and the brain and the implications of this communication are emerging concepts in pain research. Although representing a small portion of the disc degeneration syndromes, lumbar herniated discs can cause significant symptoms that may persist even after surgical interventions. Evolving evidence demonstrates that proinflammatory cytokines are a key mediator in the process of disc degeneration as well as in the pain experienced by those afflicted with lumbar herniated discs. Activated immune cells release proinflammatory cytokines, which signal the brain through humoral and neural routes. The brain responds by altering neural activity and promoting further production of proinflammatory cytokines within the brain and spinal cord. Increased local cytokine production by disc tissue irritates spinal nerve roots, resulting in pain and functional changes in neural activity. This review of the current literature explores the importance of cytokine production within the context of lumbar disc degeneration and lumbar spine pain. Furthermore, the significance of the neural-immune interaction will be examined as it relates to pain management and to patient treatment.

Humans↗
PubMedDate not supplied

Subarachnoid corticosteroid injection following inadequate response to epidural steroids for sciatica.

A review of pain clinic patients was carried out to determine whether patients who obtained limited or no relief from epidural injection of steroids derived benefit from subsequent subarachnoid steroid injections. Only 1 of 13 patients who had no benefit from epidural steroids improved following subarachnoid injection. Five of 6 patients with partial relief from epidural steroids had further improvement after subarachnoid injection.

Adult↗
PubMed1984

Modified crossed leg raising test and sciatica.

A modification of the crossed leg raising test has been helpful in identifying patients with intervertebral disc disorders. Simultaneous flexion of the neck and elevation of the contralateral leg produced pain in the ipsilateral (presenting) sciatic notch in five patients with either free fragments or herniated disc found at operation. All patients were symptom-free postoperatively.

Adult↗
PubMed1987

Sciatica: an early manifestation of thoracic vertebral osteochondroma.

We describe a 36-year-old woman with a thoracic vertebral osteochondroma who presented with radicular leg pain. This benign tumor is uncommon in the vertebral column, and radicular pain is an unusual manifestation of a thoracic spinal lesion. Myelography and computed tomography aided in diagnosis; surgical resection resulted in an excellent clinical response.

Adult↗